Abstract
Aging process is characterized by a decline in several functions leading to a decrease in the intrinsic capacity (IC), accompanied by a loss of functional reserve. The rate of decrease in IC and functional reserve is determined by the presence of some chronic diseases (including diabetes, ischemic heart disease, COPD, or osteoarthritis) and lifestyles, mainly sedentariness. In the pathway from robustness to disability there is a stage characterized by a decreased IC and a low functional reserve. This stage of high vulnerability to low power stressors is frailty. Frailty has emerged as one of the most powerful predictors of death, disability, falls, and use of resources among older people. It is present in 10%-15% of the population and in more than 50% of older people admitted to hospitals. Underlying pathophysiology includes the presence of a proinflammatory state, insulin resistance, increased oxidative stress, and changes in some hormones like testosterone, IGF-1, DHEA, or cortisol. Sarcopenia plays a substantial role in the development of frailty, although other intermediate mechanisms are also involved. Diagnosis of frailty stems from the presence of changes in several domains (gait speed, strength, body composition, activity, balance, mood, etc.) and is based on well-established criteria that should be assessed through different scales and tools. Once frailty is detected, a Comprehensive Geriatric Assessment should complete the diagnostic work, in order to develop a comprehensive plan of treatment where physical exercise program, improved nutrition, and an appropriate manage of accompanying chronic diseases and polypharmacy are mandatory.
Original language | English (US) |
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Title of host publication | Endocrinology of Aging |
Subtitle of host publication | Clinical Aspects in Diagrams and Images |
Publisher | Elsevier |
Pages | 523-545 |
Number of pages | 23 |
ISBN (Electronic) | 9780128196670 |
ISBN (Print) | 9780128223840 |
DOIs | |
State | Published - Jan 1 2020 |
Externally published | Yes |
Keywords
- Aging
- Comprehensive geriatric assessment-CGA
- Frailty phenotype
- Function
- Intrinsic capacity
- Nutrition
- Physical exercise programs
- Polypharmacy
- Sarcopenia
- Vulnerability
ASJC Scopus subject areas
- General Medicine