Frailty syndrome: a transitional state in a dynamic process.

Détails

ID Serval
serval:BIB_C4BF9EF7AFBA
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Frailty syndrome: a transitional state in a dynamic process.
Périodique
Gerontology
Auteur(s)
Lang P.O., Michel J.P., Zekry D.
ISSN
1423-0003 (Electronic)
ISSN-L
0304-324X
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
55
Numéro
5
Pages
539-549
Langue
anglais
Notes
Publication types: Journal Article ; Review Publication Status: ppublish
Résumé
Frailty has long been considered synonymous with disability and comorbidity, to be highly prevalent in old age and to confer a high risk for falls, hospitalization and mortality. However, it is becoming recognized that frailty may be a distinct clinical syndrome with a biological basis. The frailty process appears to be a transitional state in the dynamic progression from robustness to functional decline. During this process, total physiological reserves decrease and become less likely to be sufficient for the maintenance and repair of the ageing body. Central to the clinical concept of frailty is that no single altered system alone defines it, but that multiple systems are involved. Clinical consensus regarding the phenotype which constitutes frailty, drawing upon the opinions of numerous authors, shows the characteristics to include wasting (loss of both muscle mass and strength and weight loss), loss of endurance, decreased balance and mobility, slowed performance, relative inactivity and, potentially, decreased cognitive function. Frailty is a distinct entity easily recognized by clinicians, with multiple manifestations and with no single symptom being sufficient or essential in its presentation. Manifestations include appearance (consistent or not with age), nutritional status (thin, weight loss), subjective health rating (health perception), performance (cognition, fatigue), sensory/physical impairments (vision, hearing, strength) and current care (medication, hospital). Although the early stages of the frailty process may be clinically silent, when depleted reserves reach an aggregate threshold leading to serious vulnerability, the syndrome may become detectable by looking at clinical, functional, behavioral and biological markers. Thus, a better understanding of these clinical changes and their underlying mechanisms, beginning in the pre-frail state, may confirm the impression held by many geriatricians that increasing frailty is distinguishable from ageing and in consequence is potentially reversible. We therefore provide an update of the physiopathology and clinical and biological characteristics of the frailty process and speculate on possible preventative approaches.
Mots-clé
Accidental Falls/prevention & control, Aged, Aging/pathology, Aging/physiology, Biological Markers/metabolism, Frail Elderly/psychology, Humans, Mass Screening, Phenotype, Syndrome
Pubmed
Web of science
Création de la notice
15/04/2015 9:39
Dernière modification de la notice
20/08/2019 15:40
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