Present and future of the approach to frailty within the Health Promotion and Prevention Strategy’s framework in the National Health System
Abstract
Our country has achieved one of the highest life expectancies in the world, but this increase has not been matched by a similar growth in healthy life years. Maintaining people’s functional capacity as they grow older is essential to provide quality of life for the years they have gained, acting on factors that are modifiable and therefore subject to intervention, such as frailty. This is why it was one of the prioritised interventions in the Prevention and Health Promotion Strategy of the Spanish NHS, which began in 2013.
In the collective effort to meet the challenge of addressing frailty, the Autonomous Communities and Cities (AACC) have played a key role in implementing actions on the prevention of frailty and falls in the elderly. The 2019 evaluation of the 3 Consensus document on frailty and falls prevention among the elderly showed very positive data, with high or very high implementation in the AACC.
The COVID-19 pandemic has also conditioned the approach to frailty. Frailty has been shown to be a risk factor for the development of illness and death, while COVID-19 has been shown to be a frailty generator. To facilitate the care of the elderly and the approach to frailty, the Ministry of Health, within the EPSP Frailty and Falls Working Group, developed the document of Recommendations for the approach to frailty in the health crisis situation generated by the COVID-19.
The future of the approach to frailty in the EPSP is set out in the Roadmap for Addressing Frailty, developed in the framework of the EPSP and the ADVANTAGE Joint Action, which aims to contribute to making frailty a public health priority and to promote its approach at population and individual level, including prevention, early population detection and surveillance/monitoring, from an integrated and coordinated model of care, without forgetting the strengthening of training and research.
In the current situation of tension in the socio-health system, which has manifested itself since the COVID-19 crisis, it is necessary to articulate how to continue to provide quality care, not only for the acute situation, but also for other situations such as frailty, care for chronic diseases, geriatric syndromes and physical, mental and social needs. A disability-free life expectancy must be based on the promotion of active and healthy ageing to ensure that older people maintain maximum functional capacity. To this end, it is essential to assess and prevent or reverse frailty, avoiding progression to disability and further overburdening of the system, individuals, families and society as a whole.
