衰弱的評估與處置

Assessment and Management of Frailty

陳晶瑩(Chin-Ying Chen)

《台灣老年醫學暨老年學會雜誌》 16卷4期 (2021/11) Pp. 263-277

https://doi.org/10.29461/TGGa.202111_16(4).0001

摘要

衰弱的評估與處置是老年醫學的核心。由於衰弱的原因多面向，因此需有周全性評估。常見的衰弱診斷工具包括Fried表現型（Fried frailty phenotype）、Rockwood缺損累積型（accumulation of deficits）、臨床衰弱指標（clinical frailty scale）、Kihon問卷（checklist），以及衰弱功能檢測，包括握力、起立行走試驗（up and go test）、走路速度（walking speed）和起立試驗（chair rise test）等，透過各種衰弱診斷工具的介紹才能了解個工具的優缺點。本文以Kihon檢查表為主，介紹衰弱評估。至於衰弱的處置，則以治療多重疾病、提供營養支持，含乳清蛋白（whey protein）、及進行阻力運動等，統整為以“FRAILTY＂為字首策略進行衰弱防治。

關鍵字

衰弱 ； 肌少症 ； Kihon檢查表 ； 營養治療 ； 物理治療

並列摘要

Management of frailty as a core of geriatric medicine depends on comprehensive assessment of multifactorial frailty. Examining common assessment tools like the Fried frailty phenotype, Rockwood accumulation of deficits, clinical frailty scale, and Kihon Checklist, we are able to understand the strengths and deficits of different tools and the relevance and effectiveness of functional tests for frailty, notably grip strength, up and go test, walking speed, and chair rise test. This review focused on Kihon Checklist-based assessment of frailty. Management of frailty directs its attention to treating multiple comorbidity and utilizing medical nutritional therapy (including whey protein) and physical therapy (mainly resistance exercise). ＂FRAILTY＂-based strategies for prevention and management of frailty are recommended.

並列關鍵字

frailty ； sarcopenia ； Kihon Checklist ； medical nutritional therapy ； physical therapy