Primary healthcare centres

Frail older adults are those “who are at increased risk for future poor clinical outcomes, such as development of disability, dementia, falls, hospitalisation, institutionalisation, or increased mortality” [1]. As such, frailty is a state that consists of many dimensions. Physical and cognitive decline, as well as malnutrition, have been identified as the major dimensions of frailty among older adults [2]. Becoming frail is something that happens gradually. A person starts out robust (or healthy), becomes prefrail (a stage in which components of frailty become manifest), and can then evolve to become frail (which can be observed clinically easily) [3].

Current identification methods for frailty and prefrailty among older adults are resource-intensive and more efficient (but equally reliable) alternatives need to be developed [4]. A community-based, technology-supported service model for screening for frailty among older adults and training their health can be a cost-effective alternative for the clinically based services that are currently available. By combining both approaches, care is moved away from care institutions, while it allows older adults to choose which kind of service they prefer (face-to-face in the community or via online self-service technology).

This is where the PERSSILAA project comes in. In this project, researchers and eHealth developers have joined forces to create a service for screening for frailty among older adults, and to train those that are pre-frail. Screening happens at home via a paper-based or online questionnaire (during a first screening), and face-to-face at a location in the older adult’s neighbourhood (during a second screening). Training services are offered to the pre-frail, while frail older adults are referred to their General Practitioner. These training services focus on improving the older adults’ physique, cognition, and nutritional habits, and can be joined online or at a location in the older adult’s neighbourhood. The results of the screening, and individual progress during the training will be available for General Practitioners and, ultimately, will be integrated with their Health Information System.

For General Practitioners, the PERSSILAA service provides them with the option to screen their older population for frailty, and to provide services for those that are prefrail with minimal effort from their side. If the situation calls for this, they will be notified immediately of an older adult’s situation.

More information? Please watch the animation below, or contact the PERSSILAA team.

  1. European Innovation Partnership on Active and Healthy Ageing, Action Plan on Prevention and Early Diagnosis of Frailty and Functional Decline, Both Physical and Cognitive in Older People, European Union, Brussels, Belgium, 2012.
  2. I. Gomez, I. García-Sánchez, A. Carta, and J. P. Antunes, A Collection of Good Practices That Support the Prevention and Early Diagnosis of Frailty and Functional Decline, Both Physically and Cognitive, in Older People, European Commission, Brussels, Belgium, 2013.
  3. A. Sternberg, A. W. Schwartz, S. Karunananthan, H. Bergman, and A. Mark Clarfield, “The identification of frailty: a systematic literature review,” Journal of the American Geriatrics Society, vol. 59, no. 11, pp. 2129–2138, 2011.
  4. Clegg, J. Young, S. Iliffe, M. O. Rikkert, and K. Rockwood, “Frailty in elderly people,” The Lancet, vol. 381, no. 9868, pp. 752–762, 2013.