Frailty in Family Practice: Diagnosis and Management

Abstract

The frequency of frailty is increasing with the aging world population. Frailty is a long-term process and physiopathological theory describes six different dysfunction systems to be considered (i.e. hemoglobin, IL-6, IGF-1, DHEA-S, HgbA1c, triceps skinfold, fine motor movement, micronutrients). The definition of frailty is an important task. Two different models have been described: the phenotype of frailty and cumulative deficit model. Symptoms and findings of frailty are commonly non-specific. Additionally extreme fatique, unexplained weight loss and infections are observed. Frailty is a leading cause of mortality and the prevalence is 4-59% depending on the definition. It is frequent in women and the prevalence increases with age (65–69: %4;>84:%26). Although the number of studies has increased in family medicine, further studies are needed. This field needs to be prioritized in family practice.

Keywords

• Frailty, family practice, aging

Aile Hekimliğinde Düşkünlük: Tanısı ve Yönetimi

Öz

Dünya nüfusunun yaşlanmasıyla birlikte düşkünlük artmaktadır. Düşkünlük uzun erimli bir süreçtir ve fizyopatolojisine ilişkin kuram altı farklı sistemin disfonksiyonu suçlanmaktadır (Hemoglobin, IL-6, IGF-1, DHEA-S, HgbA1c, triseps kası deri kıvrım kalınlığı, ince motor hareketler, mikronutrientler (25-OH D3, B12 Vitamin, Total karotenoid). Düşkünlük aile hekimliği alanı için de önemli bir sorundur. Düşkünlüğün tanımlanması önem arz etmektedir. Iki farklı model bu sorunu tanımlamaya çalışmaktadır: Düşkünlüğün Fenotipi ve Kümülatif Defisit Modeli. Klinik olarak düşkünlüğe ilişkin semptom ve belirtiler sıklıkla non-spesifiktir. Buna ilaveten aşırı halsizlik, açıklanamayan kilo kaybı ve enfeksiyonlar gözlenebilir. Düşkünlük toplumda yaşayan bireylerin ölüm nedenleri arasında en önde yer almaktadır ve prevalansı tanımlama yöntemine göre %4-59 arasında bulunmaktadır. Kadınlarda daha sıktır ve  yaşla birlikte artmaktadır (65–69: %4; >84:%26). Düşkünlük konusunda son yıllarda aile hekimliği alanında çalışmalarda artış kaydedilse de bu konuya ilişkin yeni çalışmalara gereksinim bulunmaktadır. Bu alanının aile hekimliği tarafından ele alınması son derece önem arz etmektedir. 

Anahtar Kelimeler

• Düşkünlük, Aile Hekimliği, Yaşlanma

Kaynakça

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