Assessment and management of frailty in individuals living with dementia: expert recommendations for clinical practice

Miguel Germán Borda; Francesco Landi; Tommy Cederholm; Luis Carlos Venegas-Sanabria; Gustavo Duque; Hidetaka Wakabayashi; George E Barreto; Isabel Rodriguez-Sanchez; Marco Canevelli; Carlos Cano-Gutierrez; Mario Ulises Pérez-Zepeda; Lindsay Wallace; Kenneth Rockwood; Mario Salas-Carrillo; Martha Gjestsen; Ingelin Testad; Clive Ballard; Dag Aarsland; IPEFUND

doi:10.1016/j.lanhl.2024.100666

Assessment and management of frailty in individuals living with dementia: expert recommendations for clinical practice

Lancet Healthy Longev. 2024 Dec 27:100666. doi: 10.1016/j.lanhl.2024.100666. Online ahead of print.

Authors

Miguel Germán Borda¹, Francesco Landi², Tommy Cederholm³, Luis Carlos Venegas-Sanabria⁴, Gustavo Duque⁵, Hidetaka Wakabayashi⁶, George E Barreto⁷, Isabel Rodriguez-Sanchez⁸, Marco Canevelli⁹, Carlos Cano-Gutierrez¹⁰, Mario Ulises Pérez-Zepeda¹¹, Lindsay Wallace¹², Kenneth Rockwood¹³, Mario Salas-Carrillo¹⁴, Martha Gjestsen¹⁵, Ingelin Testad¹⁶, Clive Ballard¹⁷, Dag Aarsland¹⁸; IPEFUND

Affiliations

¹ Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain; Centro de Investigación en Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad Anáhuac México, Huixquilucan Edo de México, México; Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia. Electronic address: [email protected].
² Department of Geriatrics and Orthopedics, Fondazione Policlinico Universitario "A. Gemelli", Istituto di Ricovero e Cura a Carattere Scientifico, Università Cattolica del Sacro Cuore, Rome, Italy.
³ Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
⁴ Hospital Universitario Mayor-Méderi, Bogotá, Colombia; Rosarist Institute for the Study of Aging and Longevity, Universidad del Rosario, Bogotá, Colombia.
⁵ Dr Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, QC, Canada.
⁶ Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan.
⁷ Department of Biological Sciences, University of Limerick, Limerick, Ireland.
⁸ Geriatrics Department, Hospital Universitario Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain.
⁹ Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy; Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
¹⁰ Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana, Bogotá, Colombia.
¹¹ Centro de Investigación en Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad Anáhuac México, Huixquilucan Edo de México, México; Instituto Nacional de Geriatría, Dirección de Investigación, México City, México.
¹² Cambridge Public Health, University of Cambridge, Cambridge, UK; Geriatric Medicine Research, Dalhousie University, Nova Scotia Health Authority, Halifax, NS, Canada.
¹³ Geriatric Medicine Research, Dalhousie University, Nova Scotia Health Authority, Halifax, NS, Canada.
¹⁴ Memory Clinic, Hospital Universitario Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain.
¹⁵ Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway.
¹⁶ Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Medical School, University of Exeter, Exeter, UK.
¹⁷ Medical School, University of Exeter, Exeter, UK.
¹⁸ Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway; Centre for Healthy Brain Ageing, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.

PMID: 39736268
DOI: 10.1016/j.lanhl.2024.100666

Abstract

Frailty complicates the care of individuals with dementia, increasing their vulnerability to adverse outcomes. This Personal View presents expert recommendations for managing frailty in individuals with dementia, aimed at health-care providers, particularly those in primary care. We conducted a rapid literature review followed by a consensus process involving 18 international experts on dementia and frailty. The experts identified key areas, including diagnosis of frailty, assessment of nutritional status and nutritional management, physical activity, prevention of falls, and polypharmacy management. The recommendations emphasise early identification of frailty and a comprehensive, interdisciplinary approach to care that aims to maintain the individual's daily functioning, quality of life, and independence. The recommendations highlight the importance of tailored interventions, regular monitoring, and the integration of psychosocial support into the therapeutic approach. These recommendations address a crucial gap in existing clinical guidelines, offering practical guidance for clinicians managing frailty in individuals with dementia.

Publication types

Review