Frailty syndrome: an overview
TLDR
Frailty is a common and important geriatric syndrome characterized by age-associated declines in physiologic reserve and function across multiorgan systems, leading to increased vulnerability for adverse health outcomes, including obesity and specific diseases.Abstract:
Frailty is a common and important geriatric syndrome characterized by age-associated declines in physiologic reserve and function across multiorgan systems, leading to increased vulnerability for adverse health outcomes. Two major frailty models have been described in the literature. The frailty phenotype defines frailty as a distinct clinical syndrome meeting three or more of five phenotypic criteria: weakness, slowness, low level of physical activity, self-reported exhaustion, and unintentional weight loss. The frailty index defines frailty as cumulative deficits identified in a comprehensive geriatric assessment. Significant progress has recently been made in understanding the pathogenesis of frailty. Chronic inflammation is likely a key pathophysiologic process that contributes to the frailty syndrome directly and indirectly through other intermediate physiologic systems, such as the musculoskeletal, endocrine, and hematologic systems. The complex multifactorial etiologies of frailty also include obesity and specific diseases. Major clinical applications include risk assessment and stratification. This can be applied to the elderly population in the community and in a variety of care settings. Frailty may also be useful for risk assessment in surgical patients and those with cardiovascular diseases, cancer, or human immunodeficiency virus infection, as well as for assessment of vaccine effectiveness in older adults. Currently, exercise and comprehensive geriatric interdisciplinary assessment and treatment are key interventions for frailty. As understanding of the biologic basis and complexity of frailty further improves, more effective and targeted interventional strategies and innovative geriatric-care models will likely be developed.read more
Citations
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Journal ArticleDOI
Frailty measurement in research and clinical practice: A review
TL;DR: How well these measurements operationalise frailty according to Clegg's guidelines for frailty classification is examined - that is: their accuracy in identifying frailty; their basis on biological causative theory; and their ability to reliably predict patient outcomes and response to potential therapies.
Journal ArticleDOI
Inflammation and frailty in the elderly: A systematic review and meta-analysis.
Pinar Soysal,Brendon Stubbs,Paola Lucato,Claudio Luchini,Marco Solmi,Roberto Peluso,Giuseppe Sergi,Ahmet Turan Isik,Enzo Manzato,Stefania Maggi,Marcello Maggio,A. Matthew Prina,Theodore D. Cosco,Yu-Tzu Wu,Nicola Veronese +14 more
TL;DR: Frailty and pre-frailty are associated with higher inflammatory parameters and in particular CRP and IL-6 and further longitudinal studies are needed.
Journal ArticleDOI
The Asia-Pacific Clinical Practice Guidelines for the Management of Frailty
Elsa Dent,Christopher T. C. Lien,Wee Shiong Lim,Wei Chin Wong,Chek Hooi Wong,Tze Pin Ng,Jean Woo,Birong Dong,Shelley F. De La Vega,P J H Poi,Shahrul Bahyah Kamaruzzaman,Chang Won,Liang Kung Chen,Kenneth Rockwood,Hidenori Arai,Leocadio Rodríguez-Mañas,Li Cao,Matteo Cesari,Piu Chan,Edward M. F. Leung,Francesco Landi,Linda P. Fried,John E. Morley,Bruno Vellas,Leon Flicker +24 more
TL;DR: The recommendations provided herein are intended for use by healthcare providers in their management of older adults with frailty in the Asia Pacific region and it is proposed that regional guideline support committees be formed to help provide regular updates to these evidence-based guidelines.
Journal ArticleDOI
Exercise Attenuates the Major Hallmarks of Aging
Nuria Garatachea,Helios Pareja-Galeano,Helios Pareja-Galeano,Fabian Sanchis-Gomar,Alejandro Santos-Lozano,Carmen Fiuza-Luces,Carmen Fiuza-Luces,María Morán,Enzo Emanuele,Michael J. Joyner,Alejandro Lucia,Alejandro Lucia +11 more
TL;DR: It is proposed that, besides searching for novel pharmaceutical targets of the aging process, more research efforts should be devoted to gaining insights into the molecular mediators of the benefits of exercise and to implement effective exercise interventions for elderly people.
Journal ArticleDOI
Impact of exercise training on physical and cognitive function among older adults: a systematic review and meta-analysis.
Ryan S. Falck,Jennifer C. Davis,John R. Best,Rachel A. Crockett,Teresa Liu-Ambrose,Teresa Liu-Ambrose +5 more
TL;DR: A systematic review and meta-analysis among older adults (60+ years) suggests exercise training has a significant benefit for both physical function and cognitive function, reiterating the notion that exercise is a panacea for aging well.
References
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Journal ArticleDOI
Frailty in Older Adults Evidence for a Phenotype
Linda P. Fried,Catherine M. Tangen,Jeremy D. Walston,Anne B. Newman,Calvin H. Hirsch,John S. Gottdiener,Teresa E. Seeman,Russell P. Tracy,Willem J. Kop,B Gregory Burke,Mary Ann McBurnie +10 more
TL;DR: This study provides a potential standardized definition for frailty in community-dwelling older adults and offers concurrent and predictive validity for the definition, and finds that there is an intermediate stage identifying those at high risk of frailty.
Journal ArticleDOI
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Journal Article
Cardiovascular Health Study Collaborative Research Group : Frailty in older adults : evidence for a phenotype
Journal ArticleDOI
Frailty in elderly people
TL;DR: Developing more efficient methods to detect frailty and measure its severity in routine clinical practice would greatly inform the appropriate selection of elderly people for invasive procedures or drug treatments and would be the basis for a shift in the care of frail elderly people towards more appropriate goal-directed care.
Journal ArticleDOI
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