Sarcopenia and Physical fRailty IN older people: m.. (SPRINTT)
Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies
Date du début: 1 juil. 2014,
Date de fin: 30 juin 2019
The current healthcare systems are built around the traditional paradigm of patients suffering from a single acute illness. They are therefore largely unprepared to face the increasing demands for health services arising from the expansion of an older population with specific medical needs related to multiple chronic disorders. As a consequence, the medical conditions of a large and growing segment of the older European population are not efficiently managed by the available healthcare services. Among these conditions, the geriatric syndrome of frailty has emerged as a significant public health priority. It is defined as a multidimensional condition characterised by decreased reserve and diminished resistance to stressors. Such extreme vulnerability exposes the older individual to an increased risk of morbidity, disability, inappropriate healthcare use, institutionalization, poor quality of life, and death. Early detection and prevention of frailty are thus crucial to impede its progression and the development of its detrimental clinical consequences, while ensuring sustainability of healthcare systems of the Member States. Unfortunately, to date, no healthcare programs or pharmacological treatments are available for frail older people. This is largely due to the lack of a precise, universal definition of frailty, linked in turn to the multidimensional nature of the condition. Eventually, the existing gaps in knowledge are reflected by the absence of effective interventions. Such a barrier may be overcome by developing and validating a robust conceptual framework to achieve a practical operationalisation of frailty. This should precisely define its pathophysiological and clinical foundations, to assist in the design and implementation of specific interventions aimed at restoring robustness and delaying the onset of adverse outcomes. The present “Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies” (SPRINTT) project is specifically designed to overcome the existing barriers for an efficient public health intervention against frailty, and promote the implementation of successful aging strategies across Europe. To reach such an ambitious goal, the actions of the SPRINTT Consortium are directed towards the achievement of a consensus among academia, regulators, industry (pharmaceutical and medical devices), and patients’ representatives over (1) clear operationalisation of the presently vague concept of frailty; (2) identification of a target population with unmet medical needs; (3) evaluation and validation of methodologies for implementing preventive and therapeutic strategies among frail elders at risk of disability in the European Union; (4) definition of an experimental setting as a template for regulatory purposes and pharmaceutical investigations; (5) identification of biomarkers and health technology solutions to be implemented into clinical practice. Thus, the project is expected to pursue all the research deliverables described in nine work-packages.The SPRINTT project proposes a novel operationalisation of physical frailty recognising sarcopenia as its central biological substrate. This approach is based on the fact that the physical frailty phenotype overlaps substantially with sarcopenia. Indeed, many of the adverse outcomes of frailty are probably mediated by sarcopenia, which may therefore represent both the biological substrate for the development of physical frailty and the pathway through which the negative health outcomes of frailty ensue. Although physical frailty encompasses only a part of the frailty spectrum, the identification of a definite biological basis (i.e., skeletal muscle decline and loss of mobility function) opens new venues for the development of interventions to slow or reverse the progression of this condition. It is noteworthy that all of the components characterising the Physical Frailty and Sarcopenia (PF&S) model are measurable and qua
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