C9- THE FUTURE OF FRAILTY MANAGEMENT

Precision Medicine (P4) in the management of Frailty and Sarcopenia (Fougère.B): Precision medicine is an approach that recognizes individual variability in genes, lifestyle and environment for the individual. It recognizes that different persons require different treatment approaches. The 4 pillars of P4 medicine are: Predictive, Preventive, Personalized and Participatory. It requires an interprofessional approach. Frailty lends itself ideally to the P4 approach. We are rapidly learning that both a person’s genes and genetic instability lead to frailty. Other factors predicting frailty are telomere attrition, epigenetic alterations, mitochondrial dysfunction and stem cell exhaustion. Precision medicine on muscle quality can also help to understand the substantial variability in individual patient response to health-related outcomes and adapt intervention programs to the individual phenotype of each patient. This will necessarily involve an individualized prescription according to the functional capacity of the person, with specific recommendations about the dose (intensity, volume, and frequency), similar to those of other medications.

Rapid Detection of Frailty in Older Adults (Dent.E): The FRAIL scale is a useful tool for the rapid detection of frailty, and is suitable for application in multiple settings, including primary care, hospitals and population-wide health screening. Rapid screening of frailty with the FRAIL scale should be paired with a rapid response to frailty, which involves Comprehensive Geriatric Assessment, multidisciplinary case management, and individually tailored care plans.