Il quadro epidemiologico della fragilità nell’anziano dai risultati della Joint Action europea ADVANTAGE

Introduction Frailty is an age-related, multi-factorial functional decline, leading to increased vulnerability and adverse health outcomes. It represents one of the major challenges of global population aging, causing sufferings at individual level and threatening the long-term sustainability of healthcare systems. However, frailty is not an inevitable consequence of the ageing process, and can be prevented and potentially reversed. Reliable epidemiological data are of utmost importance to calibrate an adequate public health response. Methods Within the European Joint Action ADVANTAGE, systematic reviews of literature on prevalence, incidence and progression of frailty over time were conducted, accompanied by a survey on how Member States were addressing prevention and management of frailty. Results The scientific reviews show an overall heterogeneity of data concerning the frequency of frailty, with prevalence rates ranging from 2% to 75.6% according to classification of frailty, study design, setting and characteristics of the population (pooled prevalence estimates 12% among community-dwellers, 45% in non-community settings). There is a remarkable paucity of information about the occurrence of new cases (incidence), the progression of existing ones (longitudinal transitions and trajectories), and on associated risk and protective factors. The level of development of studies on the epidemiology of frailty is sustainable only for a few participants in the survey, including Italy, whereas is basic for the majority of countries. Conclusions Further standardized and well-designed prospective studies of frailty, including the analysis of health and socioeconomic factors associated with its development and progression, are needed to guide policy makers and healthcare providers towards actions addressed to high-risk groups.