Age-related changes in the elderly
Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth in Musculoskeletal Trauma in the Elderly, 2016
Sarcopenia is the term for age-related loss of muscle mass. Muscle mass peaks at around 40 years of age and then steadily declines, a process which can be delayed and lowered through regular physical activity34 and a well-balanced protein-rich diet.3Sarcopenia is defined as a measured loss of muscle mass in combination with a loss of strength (mainly determined by handgrip strength) or function (mainly measured by gait speed). Sarcopenia is relevant to older adults as it directly affects their functionality. It is closely linked to frailty syndrome, characterized by decreased tolerability and responsiveness to internal and external stressors.35,36 Frailty can be separated into physical, psychological and social frailty. Physical frailty is central to orthogeriatrics and can quite easily be determined by the Fried criteria.37
Death wishes of the very old 1
Govert den Hartogh in What Kind of Death, 2023
Not only the individual conditions by themselves are to be considered medically classifiable diseases or ailments. What as a result of the process of ageing understood in the way I described is most characteristic of old age is the plurality of health deficits, interacting with each other, and creating a decreased resistance to environmental stressors. This condition is by now known as ‘frailty’ or the ‘frailty syndrome’ and it is increasingly measured by means of a ‘frailty index’.21 The concept of frailty presents itself as an important new medical classification, because at the dawn of the ‘fourth age’ it has both predictive value for incomplete recovery from acute ailments, falling down, loss of control, hospitalization and death, as well as a guiding value for medical efforts, e.g. as regards nutrition and physical activity, and in particular for adapted treatment of the component diseases.
Health in later life
Liam J. Donaldson, Paul D. Rutter in Donaldsons' Essential Public Health, 2017
There are two main concepts of frailty. The frailty phenotype sees frailty as a biological syndrome affecting multiple body systems. This phenotype comprises several health deficits (e.g. extreme fatigue, slowness, weakness, low energy expenditure and unexplained weight loss). Other deficits in health as a part of the frailty syndrome may include adverse changes in mental health in both affect and cognition. Conversely, the frailty index uses a cumulative deficit approach. Frailty is interpreted as a multidimensional risk state. It combines symptoms, diseases and disabilities to predict different degrees of frailty. Within clinical settings, various stages of frailty and fitness of older people require different care plans and supportive services (Table 11.7).
Assessment of frailty syndrome using Edmonton frailty scale in Polish elderly sample
Published in The Aging Male, 2019
Beata Jankowska-Polańska, Bartosz Uchmanowicz, Hanna Kujawska-Danecka, Katarzyna Nowicka-Sauer, Anna Chudiak, Krzysztof Dudek, Joanna Rosińczuk
“Frailty syndrome” is associated with the elderly and explained as the syndrome of the reserve deficiency or the syndrome of the fragility. There is no uniform definition of this syndrome, but the most citable is the definition presented by a consensus group consisting of delegates from 6 major international, European, and US societies created four major consensus points on a specific form of frailty: physical frailty [2]. This definition says that FS is: “A medical syndrome with multiple causes and contributors that is characterized by diminished strength, endurance and reduced physiologic function that increases an individual’s vulnerability for developing increased dependency and/or death.” The other consensus says about the prevention of the frailty syndrome and the implementing of the suitable interventions, such as the suitable exercises and the motor rehabilitation, the protein and calorific supplementation, Vitamin D supplementation and the decrease of the polypragmasy [3].
Relationship between the FRAX index and physical and cognitive functioning in older people
Published in Annals of Medicine, 2018
Yolanda González Silva, Laura Abad Manteca, Henar de la Red Gallego, Mónica Álvarez Muñoz, MaríaLuisa Rodríguez Carbajo, Teresa Murcia Casado, Lourdes Ausín Pérez, Jésica Abadía Otero, José-Luis Pérez-Castrillón
The variables evaluated from part of the frailty syndrome which has been described as a dynamic condition affecting the individual experiencing losses in one or more domains of human functioning (physical, psychological, social) and which is caused by different variables and increases the risk of adverse events [21]. These models are associated with age and could reflect the natural history of aging [22]. Unfortunately, there is no single validated index to assess frailty in clinical practice [23]. Some indices used have been associated with an increased risk of fractures [24] and falls [25]. The Glow cohort and the CaMos cohort used different indices to assess the relationship between frailty and fractures, but both include many of the parameters assessed in our study. The Glow fragility fractures index variables included 15 items on comorbidity, 12 on basic activities of daily life (similar to BI), 6 items on signs and symptoms (fullness of life, energy, exhaustion, tiredness, self-evaluated pain/discomfort, unintentional weight loss). The frailty index used in the CaMos cohort included 30 items, 13 referring to pathology, 5 on functional aspects (vision, hearing, walking, manual dexterity/use of tools and cognition) and 12 on general health and daily activities. Some authors have proposed adding frailty to the FRAX index to improve its predictive value [26].
Depression Severity, but Not Cognitive Impairment or Frailty, is Associated with Disability in Late-Life Depression
Published in Clinical Gerontologist, 2020
Ruth T. Morin, Philip Insel, David Bickford, Craig Nelson, R. Scott Mackin
When looking at CI and its relation to disability in the LLD population, it is also important to consider the potential role of frailty. Frailty is conceptualized as “a biologic syndrome of decreased reserve and resistance to stressors, resulting from cumulative declines across multiple physiologic systems and causing vulnerability to adverse outcomes (Fried & Mor, 1997).” The risk of frailty increases proportionately with age (Clegg, Young, Iliffe, Rikkert, & Rockwood, 2013), with associated falls and hospitalizations increasing the proportion of disability and risk of death (Ahmed, Mandel, & Fain, 2007). The frailty syndrome, which may include weakness, slowness, weight loss, or low levels of activity, overlaps significantly with symptoms of LLD (Brown et al., 2016). Additionally, depressive symptoms have been found to increase the risk for physical frailty, especially in the presence of medical comorbidities and impaired cognition (Vaughan, Corbin, & Goveas, 2015). However, frailty as a contributing factor to disability in LLD has been understudied, particularly in the context of concurrent CI.
Related Knowledge Centers
- Ageing
- Disability
- Geriatrics
- Dementia
- Cachexia
- Skeletal Muscle
- Cytokine
- Old Age
- Risk Factor
- Sarcopenia