Abstract
Background: Population screening for health conditions is common in many health systems for people of all ages. Such screening programmes often target specific diseases, such as cancer or diabetes to identify early signs of the disease and improve treatment outcomes. For older people, increased risk of falls as well as age-related conditions such as sarcopenia and frailty, have all been recommended for screening to facilitate early interventions, such as physical activity. A comprehensive frailty screening approach has been implemented in the UK based on the accumulation of deficits approach. The electronic Frailty Index (eFI) uses electronic health records data to identify older people who might be moderately or severely frail, with diagnosis confirmed using a tool such as the Clinical Frailty Scale. Although this approach is successful, data in electronic health records can be incomplete, particularly among ethnic minority groups who are less likely to visit their GP. This could mean that many frail older people are undetected. In terms of physical frailty and sarcopenia, the UK does not have a screening programme in place, although tools such as the SARC-F, FRAIL, or gait speed tests are recommended. The main issues with a proactive approach to screening for frailty and sarcopenia, as recommended by international guidelines, is that there is a lack of public awareness of both conditions, while for many older people it is difficult to access primary care. Other issues include whether older adults accept screening for these conditions, while healthcare professionals in primary care have limited time to perform opportunistic screening. The aim of this study is to develop a screening programme for physical frailty and sarcopenia in community dwelling older people from a culturally diverse population.
Approach: This study uses a co-production approach that involves a wide range of stakeholders in the area covered by the Bedford, Luton, and Milton Keynes Integrated Care Service (BLMK ICS), which has one of the most culturally diverse populations in the UK. These stakeholders include older people from a range of different cultural backgrounds, community leaders, members of local authorities, as well as a wide range of healthcare professionals. Initial focus groups will be held within each group to identify barriers and facilitators to physical frailty and sarcopenia screening, as well as the components required in the screening programme. The screening programme that will be developed will use the Behaviour Change Wheel as an organisational tool to ensure that behaviour change is a core component of the programme. Following on from the initial focus groups, the screening programme will be co-produced by a group of stakeholders from the initial groups.
Implications: This will be the first example of a co-produced screening programme for physical frailty and sarcopenia. The programme will then be evaluated in a culturally diverse population of older people. This will directly impact both policy and practice and will proactively identify older people at risk of physical frailty and sarcopenia.