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The Frailty Syndrome: Definition and Natural History

2010; Elsevier BV; Volume: 27; Issue: 1 Linguagem: Inglês

10.1016/j.cger.2010.08.009

1879-8853

Qian‐Li Xue,

Health Systems, Economic Evaluations, Quality of Life

The recent work on the natural history of frailty has advanced the understanding of the aging process and its potential physiologic correlates. The ongoing debate on the operational definition of frailty, its subdomains (eg, physical vs cognitive), and its relationship with aging, disability, and chronic diseases41Fried L.P. Ferrucci L. Darer J. et al.Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care.J Gerontol. 2004; 59: 255-263Crossref Google Scholar, 42Hogan D.B. MacKnight C. Bergman H. Models, definitions, and criteria of frailty.Aging Clin Exp Res. 2003; 15: 1-29PubMed Google Scholar, 43Bergman H. Ferrucci L. Guralnik J. et al.Frailty: an emerging research and clinical paradigm–issues and controversies.J Gerontol. 2007; 62: 731-737Crossref Scopus (844) Google Scholar, 44Avila-Funes J.A. Amieva H. Barberger-Gateau P. et al.Cognitive impairment improves the predictive validity of the phenotype of frailty for adverse health outcomes: the three-city study.J Am Geriatr Soc. 2009; 57: 453-461Crossref PubMed Scopus (385) Google Scholar, 45Sarkisian C.A. Gruenewald T.L. John Boscardin W. et al.Preliminary evidence for subdimensions of geriatric frailty: the MacArthur study of successful aging.J Am Geriatr Soc. 2008; 56: 2292-2297Crossref PubMed Scopus (73) Google Scholar signals that more work is necessary to better define and quantify reserve and resilience, the hallmarks of frailty.16Fried L.P. Hadley E.C. Walston J. et al.From bedside to bench: research agenda for frailty.Sci Aging Knowledge Environ. 2005; 2005: 24Crossref Scopus (233) Google Scholar, 46Varadhan R. Seplaki C.L. Xue Q.L. et al.Stimulus-response paradigm for characterizing the loss of resilience in homeostatic regulation associated with frailty.Mech Ageing Dev. 2008; 129: 666-670Crossref PubMed Scopus (100) Google Scholar Despite this debate, researchers and clinicians have no disagreement on the severe impact of frailty on older adults, their caregivers, and on society as a whole. Although specific treatments for frailty are yet to be developed and tested, the existing clinical measures of frailty provide useful means for identifying high-risk individuals and, therefore, could lead to improved treatment, decision making, and management of care by taking into account individual vulnerabilities and propensity for adverse health outcomes.