The bio-psycho-social frailty: a key to the integrate territorial and hospital care in Europe

Demographic changes have forced communities and people themselves to reshape ageing concepts and approaches and try to develop actions towards Active and Healthy Ageing (AHA). The prevalence of frailty at population-level is expected to increase in Europe, changing the focus of Public Health. The European Innovation Partnership on Active and Healthy Ageing (EIPonAHA), a private public partnerships (PPP) launched by the European Commission (EC) is aimed at developing new solutions to facilitate AHA. The partnership combined the view on frailty coming from public health as well as the clinical management, and managed to overcome barriers between these two worlds. Bio-Psycho-Social frailty represents a synthetic indicator providing an effective basis to overcome a silos approach that is often performed by health and social professionals working in the field. The A3-Action Group on ' Lifespan Health Promotion & Prevention of Age-Related Frailty and Diseases” proposes good practice models to achieve and support the healthy ageing of European citizens using a bottom-up approach targeting the prevention of frailty and subsequent functional decline. Multiple factors were highlighted by the group as useful for healthcare planning: malnutrition, polypharmacy, impairment of physical function and social isolation were targeted to mitigate frailty and its consequences. Integrated health and social care is a key factors to affect ageing positively either in the field of prevention of functional decline and in the field of care. Studies focused on the management of frailty highlighted that tailored interventions can improve physical performance and reduce adverse outcomes. A crucial role is played by training of health personnel and education at population level in order to achieve a new awareness about AHA trajectory.

The European Innovation Partnership on Active and Healthy Ageing Synergies: Protocol for a Prospective Observational Study to Measure the Impact of a Community-Based Program on Prevention and Mitigation of Frailty (ICP - PMF) in Community-Dwelling Older Adults

Aim of this paper is to describe the protocol of the study "Impact of a Community-based Program on Prevention and Mitigation of Frailty in community-dwelling older adults" developed in the framework of the European Innovation Partnership on Active and Healthy Ageing. This proposal has been developed by the Partnership Action groups on frailty, fall prevention and polypharmacy in older. The proposal wants to assess the impact of community-based programs aimed to counteract three main outcomes related to frailty: hospitalization, institutionalization and death. Bringing together researchers from seven European countries, the proposal aims to achieve the critical mass and the geographical extension enough to provide information useful to all older European citizens. An observational study will be carried out to calculate the incidence of the different outcomes in relation to the various interventions that will be assessed; results will be compared with data coming from already established national, regional and local dataset using the observed/expected approach. The sample will be made up by at least 2000 citizens for each outcome. All the citizens will be assessed at the baseline with two multidimensional questionnaires: the RISC questionnaire and the Short Functional Geriatric Evaluation questionnaire. The outcomes will be assessed every six-twelve months.