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Thema kwetsbaarheid

Over kwetsbaarheid, multimorbiditeit en beperkingen

  • Wetenschappelijk artikel
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Tijdschrift voor VerpleeghuisGeneeskunde

Abstract

Frailty is characterised by an unstable condition with little reserve capacity to withstand stress. It is a relatively new concept, and the question is how it is related to commonly used concepts such as multimorbidity and functional limitations. In this contribution, data from the nationally representative Longitudinal Aging Study Amsterdam are used to present the prevalence of frailty and the overlap between frailty, multimorbidity and functional limitations for the Dutch population of 65 years and over. Also, it is examined if there are indications for a rising trend in the prevalence. Regardless of multimorbidity and functional limitations, frailty added predictive value to the outcomes functional decline, admission to an institution, and mortality. Finally, although the prevalence of frailty is not expected to rise until 2020, the absolute number of frail older persons increases with a factor 1.5. It seems therefore important to make efforts to prevent or postpone frailty as much as possible. These efforts should be in the area of tertiary prevention.

Samenvatting

Kwetsbaarheid (frailty) wordt gekenmerkt door een wankel evenwicht met weinig reserve om verstoringen op te vangen. Het is een relatief nieuw begrip, en het is de vraag hoe dit zich verhoudt tot veelgebruikte gezondheidsaspecten als multimorbiditeit en functionele beperkingen. In deze bijdrage wordt met gegevens van de landelijk representatieve Longitudinal Aging Study Amsterdam de prevalentie van kwetsbaarheid en de overlap tussen kwetsbaarheid, multimorbiditeit en functionele beperkingen gepresenteerd voor de bevolking van 65 jaar en ouder.Tevens wordt nagegaan of er aanwijzingen zijn dat de prevalentie van kwetsbaarheid aan het stijgen is. Ongeacht multimorbiditeit en functionele beperkingen voegde kwetsbaarheid voorspellende waarde toe voor functionele achteruitgang, opname in een zorginstelling, en sterfte.Tenslotte, hoewel de prevalentie van kwetsbaarheid naar verwachting tot 2020 niet zal toenemen, groeit het absolute aantal kwetsbare ouderen met een factor 1,5. Het lijkt dus van belang om kwetsbaarheid zo veel mogelijk te voorkomen of uit te stellen.Tertiaire preventie is daarvoor aangewezen.

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Notes

  1. De methode Edwards-Nunnally is ontwikkeld om pretest-posttest verschillen te bepalen, en berekent ‘relevante verandering’ op grond van de betrouwbaarheid van het meetinstrument, het gemiddelde en het betrouwbaarheidsinterval van de pretest-schatting. De methode houdt daardoor rekening met regressie naar het gemiddelde.

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Authors and Affiliations

  1. EMGO-Instituut, VUmc, Amsterdam., The Netherlands

    Dorly J. H. Deeg

  2. McGill University, Montreal, Canada

    Martine T. E. Puts

  3. www.bsl.nl/shop/tijds-verpleeghuisgeneeskunde-1386-1514.html

    Dorly J. H. Deeg

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  1. Dorly J. H. Deeg
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  2. Martine T. E. Puts
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Correspondence to Dorly J. H. Deeg.

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Deeg, D.J.H., Puts, M.T.E. Thema kwetsbaarheid. TVVG 32, 178–185 (2007). https://doi.org/10.1007/BF03075283

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