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<title>フレイルサポート医のための疾患治療マニュアル | 株式会社文光堂</title>


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<meta name="description" content="超高齢社会の日本でも近年注目が集まる「フレイル」．本書では，フレイルの全体像を理解し，実際に診断・治療していくための知識をコンパクトに集約した．総論では，フレイルの定義や評価法，食事・運動療法，地域資源の活用などの基本をおさえる．各論では，フレイルと関連する25の疾患・老年症候群を網羅．5つのQ&amp;Aに沿って，フレイルの発症リスクや，フレイルを併発した際の治療の注意点を整理した．巻末付録として，「か">

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		<h1 class="catchCopy">フレイルの診断・治療のために．この一冊ですっきり理解，しっかり実践！</h1>
		

		<h1 class="title titleWidth">フレイルサポート医のための疾患治療マニュアル<span class="version"></span></h1>
		

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					監修：日本老年医学会
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					編集：東京都健康長寿医療センター
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				<ul class="property"><li class="disc">B5判・156頁・4色刷</li><li class="disc">ISBN&nbsp;978-4-8306-2066-9</li><li class="disc">2022年8月23日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">超高齢社会の日本でも近年注目が集まる「フレイル」．本書では，フレイルの全体像を理解し，実際に診断・治療していくための知識をコンパクトに集約した．総論では，フレイルの定義や評価法，食事・運動療法，地域資源の活用などの基本をおさえる．各論では，フレイルと関連する25の疾患・老年症候群を網羅．5つのQ&Aに沿って，フレイルの発症リスクや，フレイルを併発した際の治療の注意点を整理した．巻末付録として，「かかりつけ医用 後期高齢者の質問票対応マニュアル」も収録．</section><section class="preface">序　文<br><br>　フレイルに関しては，1994年にRockwoodらが，暦年齢と生物学的年齢の違い，すなわち生理的老化と病的老化の間で，介護力と介護負担のバランスが重要であると指摘したが<sup> 1)</sup>，2001年にFriedらが，その定義をコホートでの集団で遺伝的素因と環境要因によって形成された臨床像に基づいた分類，すなわち表現型モデルとして（Cardiovascular Health Study：CHS）基準を発表し<sup> 2)</sup>，疫学研究が指数関数的に盛んになり，わが国にも輸入され，現在に至っている．<br>　一方，フレイルの定義は「老化や慢性疾患の積み重なりによってストレスに脆弱になること」というRockwoodの考えが継承されているが，老年症候群の積み重ねをカウントするFrailty Index（累積モデル）は煩雑性のため，医療機関でも普及しなかった．近年，世界的な高齢社会の到来によって，各科はフレイルの概念を加味した診療が成績向上のため必須であることを認識し始め，慢性疾患の影響を受けた，フレイルのより多様な臨床表現形が脚光を浴びることになってきた．歯科口腔領域の口腔機能低下症が，わが国発の概念「オーラルフレイル」 として次第に世界に認知され始めたのが象徴的であるが，頻尿，視力低下，脆弱性皮膚など，各領域の関心の急速な高まりは枚挙にいとまがない．<br>　これらは，フレイル高齢者のケアに直結するだけに，表現型モデルによる診断だけでは十分な臨床指針になり得ない．ところが，2020年に後期高齢者健診が努力義務となり，フレイルのスクリーニングが一部の老年症候群を含んで始まったが，臨床上の工夫やケアプランの立案に十分な指針はいまだ存在しなかった．相談を受ける，かかりつけ医や看護師，栄養士などは大いに戸惑っているはずである．<br>　もとより日進月歩で急速にエビデンスが集積してきている領域であり，今日の最新の情報の集積ではあるが，本書はこれらの求めに正面から向き合って作成した．少しでも現場の助けになれば幸いである．<br><br>2022年8月<br>編集代表　東京都健康長寿医療センター理事長<br>鳥羽　研二<br><br><br>1）Rockwood K，et al：Frailty in elderly people：an evolving concept． CMAJ 1994，150：489-495<br>2）Fried L，et al：Frailty in older adults：evidence for a phenotype．J Gerontol A Biol Sci Med Sci 2001，56：M146-M156</section><section class="indexes">総　論			<br>　1　フレイルとは何か<br>　2　フレイルの評価法<br>　3　フレイル対策としての運動療法<br>　4　フレイル対策としての食事療法　<br>　5　サルコペニア，ロコモティブシンドローム，カヘキシア<br>　　COLUMN　社会的フレイル<br>　6　後期高齢者の質問票の活用法<br>　7　地域のフレイル対策<br><br>各論A　フレイルと関連する疾患			<br>　1　糖尿病とフレイル<br>　2　高血圧・起立性低血圧とフレイル<br>　3　冠動脈疾患とフレイル<br>　4　心房細動とフレイル<br>　5　心不全とフレイル<br>　6　慢性腎臓病（CKD）とフレイル　<br>　　COLUMN　貧血とフレイル<br>　7　透析患者とフレイル<br>　8　COPDとフレイル　<br>　9　肝硬変とフレイル<br>　10　肥満・サルコペニア肥満とフレイル<br>　11　骨粗鬆症とフレイル<br>　12　認知機能障害とフレイル<br>　　COLUMN　脳卒中・大脳白質病変とフレイル<br>　13　うつとフレイル<br>　　COLUMN　パーキンソン病とフレイル<br>　14　multimorbidity（多疾患罹患状態）とフレイル<br>　　COLUMN　高齢者に対する外科手術とフレイル<br><br>各論B　フレイルと関連する老年症候群			<br>　1　転倒とフレイル<br>　2　低栄養とフレイル<br>　3　摂食嚥下障害（dysphagia）とフレイル<br>　4　口腔機能低下（オーラルフレイル）とフレイル<br>　5　不眠とフレイル<br>　6　慢性疼痛とフレイル　<br>　7　便秘とフレイル<br>　8　排尿障害とフレイル<br>　　COLUMN　スキンフレイル<br>　9　ロービジョン（視力障害）とフレイル<br>　10　難聴とフレイル<br>　11　ポリファーマシーとフレイル<br>			<br>●付　録　かかりつけ医用 後期高齢者の質問票対応マニュアル<br>●索　引</section></article>
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