Interdisciplinary perspectives on functional maintenance and frailty in people living with moderate to severe dementia

Dementia is one of the most important causes of functional loss and disability. Besides cognitive decline, people with dementia in moderate to severe stages are in a vulnerable situation due to many different stressors, including other diseases, social vulnerability, malnutrition, and geriatric syndromes. These factors significantly impact their health and accelerate the functional loss and the disability process and worsening the quality of life of the person living with the disease and the carer. When many different conditions collide in one individual the risk of developing frailty increases. Frailty is a condition characterized by an increased vulnerability to stressors, and it has been strongly reported it increases the risk of many different negative outcomes such as falls, faster cognitive decline, hospitalizations, disability, nursing home admission, mortality among many others. Frailty is a condition that is susceptible to change with simple and accessible interventions such as exercise and nutritional counseling and supplementation. However, it is not commonly identified or treated in clinical practice and is especially ignored in the standard dementia care approach. Generating guidelines that allow clinicians to incorporate frailty mitigation, detection, and management in the current dementia management would without a doubt change the course of the disability slope and most importantly improve the quality of life of the people who live with dementia. Therefore, for this call, we propose to gather a group of expert scientists and physicians related with dementia and frailty from different perspectives to create the first international guidelines to mitigate, identify and treat frailty in people with moderate and severe dementia in clinical practice and the community, and to create new research ideas that allow a future better care for the people living with the disease.