Toward an Understanding of Frailty

Hamerman, David

doi:10.7326/0003-4819-130-11-199906010-00022

Cited by 393 publications

(241 citation statements)

References 95 publications

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“…A more advanced stage may be observed in more debilitated populations, such as in nursing homes. This phenotype may not, however, fully explain the more subtle biologic underpinnings of decreased reserves and ability to maintain homeostasis (11)(12)(13), which may be latent prior to an insult, but be a basis for vulnerability to stressors (10,11,14). Further understanding of the basis for risk associated with frailty may ultimately be found in the alterations in multisystem function, complexity, and reserve with aging (12).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Frailty in Older Adults: Evidence for a Phenotype

Fried¹,

Tangen²,

Walston³

et al. 2001

The Journals of Gerontology Series A: Biological Sciences and M

19,220

415

19,090

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Section: Discussionmentioning

confidence: 99%

“…Increasingly, geriatricians define frailty 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 (9)(10)(11)(12)(13). This concept distinguishes frailty from disability (9,10,14,15).…”

mentioning

confidence: 99%

Frailty in Older Adults: Evidence for a Phenotype

Fried¹,

Tangen²,

Walston³

et al. 2001

The Journals of Gerontology Series A: Biological Sciences and M

19,220

415

19,090

View full text Add to dashboard Cite

“…Uma expressão complexa e cumulativa de respostas homeostá-ticas alteradas aos múltiplos estressores, resultando em desequilíbrio metabólico, pode ser resultante da fragilidade 8 . A característica essencial de fragilidade é a noção do risco decorrente da instabilidade 9 .…”

Section: Fragilidade Como Conceitounclassified

“…O conhecimento sobre os eventos que resultam nesta condição é limitado e alguns pesquisadores vêm buscando de forma intensa a identificação da etiologia e as características dessa síndrome [7][8][9][10][11]13 . 15, as pesquisas são realizadas por diferentes especialistas, subdivididas em 11 domínios: 1) história, conceitos e definições; 2) bases biológicas; 3) serviços de saúde; 4) bases sociais; 5) prevalência; 6) história natural e fatores de risco; 7) impacto da fragilidade; 8) identificação; 9) prevenção e conduta terapêutica; 10) ambiente e tecnologia; 11) política social e de saúde.…”

Section: Fragilidade Como Conceitounclassified

Síndrome da fragilidade no idoso: importância da fisioterapia

Macedo

Gazzola

Najas

2008

Arq. Bras. Ciên. Saúde

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ResumoA fragilidade é conceituada como uma síndrome clínica, que pode ser identificada por perda de peso involuntária, exaustão, fraqueza, diminuição da velocidade da marcha e do equilíbrio e diminuição da atividade física. Cada uma dessas manifestações clínicas é preditora de uma série de reações adversas (quedas, hospitalização, institucionalização, declínio funcional e morte). O objetivo desta revisão de literatura foi expor os elementos sobre a Síndrome da Fragilidade dos Idosos, em uma revisão narrativa da literatura, dando um panorama geral sobre epidemiologia, tendências atuais, ciclo da fragilidade, sarcopenia, alterações imunológicas, alterações neuroendócrinas, diagnósticos clínico, laboratorial e diferencial e as possibilidades de intervenções fisioterapêuticas. Para esses fins, realizou-se revisão bibliográfica da literatura nacional e internacional sobre o tema. Com o conhecimento de estudos envolvendo idosos frágeis, é possível planejar as estratégias voltadas para a identificação da parcela da população que mais se beneficiaria de ações para postergar, atenuar e, se possível, reverter tais desfechos.Palavras-chave: Idoso; fragilidade; envelhecimento; sarcopenia; exercício físico. AbstractThe frailty syndrome is a clinical syndrome that may be identified by involuntary loss of weight, exhaustion, weakness, decrease of walking rate and balance, and decrease of physical activity. Each one of these clinical manifestations predicts a series of adverse reactions (falls, hospitalization, institutionalization, functional decline, and death). The aim of this literature review was to expose the elements on Frailty Syndrome in the elderly in a narrative literature review, providing a general panorama upon epidemiology, actual trends, frailty cycle, sarcopenia, immunological disorders, neuroendocrinal disorders, clinical, laboratorial and differential diagnosis, and the possibilities of physiotherapeutic intervention. Therefore, a national and international literature review on the subject was performed. By knowing studies involving fragile elderly patients, it is possible to plan strategies towards the identification of parcel of the population that would benefit the most from actions to delay, to attenuate and, if possible, to revert such manifestations.

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“…Falls and the resultant trauma are thought to be related to a variety of decreased physical functions that are sometimes grouped together as measures of biomarkers of aging or frailty. Frailty results from declines in multiple systems (Bortz 1993;Campbell and Buchner 1997;Hamerman 1999). It differs from disability or morbidity in that it is meant to describe a general decrease in functional status (Chin et al, 1999;Fried et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Biomarkers of aging and falling: The Beaver Dam eye study

Knudtson

Klein

2009

Archives of Gerontology and Geriatrics

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Falls are an important cause of morbidity in older adults and are an important source of health care spending. We hypothesize that falls are associated with systemic biomarkers of aging. The following functions, measured at the 1998-2000 and 2003-05 examinations of the Beaver Dam Eye study, were considered to be biomarkers of aging (frailties): poorer visual acuity, contrast sensitivity or discrepant vision between the eyes, inability to rise from a chair, slower gait time, poorer hand grip strength, and lower peak expiratory flow rate. We found that poorer values on biomarkers of aging (frailties) at the 1998-2000 examination were associated with 2 or more reported falls in the past year at the 2003-05 examination (p < 0.05 for all markers except peak expiratory flow rate). When the markers were combined as an index of biological aging (frailty), the index was significantly associated with falls after controlling for significant confounders (odds ratio per 1 step increase in the index: 1.33; 95% confidence interval = CI = 1.13-1.57) We conclude that biomarkers of aging, including any of three measures of visual function, are associated with falls. Improvement in these functional measures may lead to decreased risk of falls.

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Toward an Understanding of Frailty

Cited by 393 publications

References 95 publications

Frailty in Older Adults: Evidence for a Phenotype

Frailty in Older Adults: Evidence for a Phenotype

Síndrome da fragilidade no idoso: importância da fisioterapia

Biomarkers of aging and falling: The Beaver Dam eye study

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