New perspectives on frailty in light of the Global Leadership Initiative on Malnutrition, the Global Leadership Initiative on Sarcopenia, and the WHO's concept of intrinsic capacity: A narrative review

Elena Muñoz-Redondo; Andrea Morgado-Pérez; María José Pérez-Sáez; Julio Pascual; Marta Tejero-Sánchez; Yulibeth G Curbelo; Marc Terradellas-Fernández; Delky Meza-Valderrama; Olga Vázquez-Ibar; Cédric Annweiler; Dolores Sánchez-Rodríguez; Ester Marco

doi:10.1016/j.maturitas.2023.107799

New perspectives on frailty in light of the Global Leadership Initiative on Malnutrition, the Global Leadership Initiative on Sarcopenia, and the WHO's concept of intrinsic capacity: A narrative review

Maturitas. 2023 Nov:177:107799. doi: 10.1016/j.maturitas.2023.107799. Epub 2023 Jul 20.

Affiliations

¹ Physical Medicine and Rehabilitation Department, Hospital del Mar - Centre Esperança, Avinguda Sant Josep de la Muntanya 12, 08024 Barcelona, Spain; Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain.
² Nephrology Department, Hospital del Mar, Passeig Marítim de la Barceloneta 25-29, 08003 Barcelona, Spain.
³ Nephrology Department, Hospital del Mar, Passeig Marítim de la Barceloneta 25-29, 08003 Barcelona, Spain; Nephrology Department, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041 Madrid, Spain.
⁴ Tecnocampus, Universitat Pompeu Fabra, Research group in Attention to Chronicity and Innovation in Health (GRACIS), Carrer d'Ernest Lluch, 32, 08302 Mataró, Barcelona, Spain.
⁵ Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain; Physical Medicine and Rehabilitation Department, National Institute of Physical Medicine and Rehabilitation (INMFRE), City 0819, Panama; Geriatrics Department, Hospital del Mar - Centre Fòrum, Carrer de Llull 410, 08019 Barcelona, Spain.
⁶ Geriatrics Department, Hospital del Mar - Centre Fòrum, Carrer de Llull 410, 08019 Barcelona, Spain; Faculty of Medicine, Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
⁷ Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France.
⁸ Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain; Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium; WHO Collaborating Center for Public Health aspects of musculoskeletal health and ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Campus Sart Tilman, Avenue Hippocrate (Bât 23), 4000 Liège, Belgium. Electronic address: dolo.sanchezr@gmail.com.
⁹ Physical Medicine and Rehabilitation Department, Hospital del Mar - Centre Esperança, Avinguda Sant Josep de la Muntanya 12, 08024 Barcelona, Spain; Rehabilitation Research Group, Hospital del Mar Medical Research Institute, Doctor Aiguader 88, 08003 Barcelona, Spain; Faculty of Medicine, Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain.

PMID: 37499428
DOI: 10.1016/j.maturitas.2023.107799

Abstract

This review gathered the evidence on the epidemiology of frailty, as well as on screening and diagnostic tools, and new perspectives, in light of the latest global frameworks in malnutrition, sarcopenia, and the World Health Organization's concept of intrinsic capacity. Frailty is a worldwide health challenge and highly prevalent in older adults and the population with chronic diseases independent of age. Regardless of the particular concept of frailty, many screening and diagnostic tools are able to identify frailty in older people, but none of them has shown superiority in every population and healthcare setting. Physical, cognitive, and social components are part of the larger context of frailty. The latest evidence-based initiatives on frailty recommend the use of validated tools to identify frailty's different components, tailored to the needs of specific populations and healthcare systems. Unintentional weight loss is a shared criterion between physical frailty and malnutrition according to the Global Leadership Initiative on Malnutrition criteria. A new definition of sarcopenia by the Global Leadership Initiative on Sarcopenia is awaited, but at present physical frailty shares with sarcopenia the criteria of low muscle function and physical performance (severity grading) according to the revised consensus of the European Working Group on Sarcopenia in Older People (EWGSOP2). The EWGSOP2 includes both muscle mass and function, with most scientific groups agreeing that function is a key hallmark of sarcopenia. The concept of intrinsic capacity features the reserves and positive aspects of aging, and responds to ageism by addressing the deficit model approach. Intrinsic capacity is an emerging, person-centered and public health indicator, aimed at preserving health at mid-life and beyond, to move towards a better aging process in the Decade of Healthy Aging 2020-2030.

Keywords: EWGSOP2; Frailty; GLIM criteria; Intrinsic capacity; Older people; Sarcopenia.

Publication types

Review

MeSH terms

Aged
Frailty* / diagnosis
Humans
Leadership
Malnutrition* / diagnosis
Malnutrition* / epidemiology
Sarcopenia* / epidemiology
World Health Organization