The Frailty Syndrome: Definition and Natural History

Department of Medicine, Johns Hopkins University School of Medicine, 2024 East Monument Street, Suite 2-700, Baltimore, MD 21205-1179, USA.
Clinics in Geriatric Medicine (Impact Factor: 3.19). 02/2011; 27(1):1-15. DOI: 10.1016/j.cger.2010.08.009
Source: PubMed

ABSTRACT This article reviews the current state of knowledge regarding the epidemiology of frailty by focusing on 6 specific areas: (1) clinical definitions of frailty, (2) evidence of frailty as a medical syndrome, (3) prevalence and incidence of frailty by age, gender, race, and ethnicity, (4) transitions between discrete frailty states, (5) natural history of manifestations of frailty criteria, and (6) behavior modifications as precursors to the development of clinical frailty.

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    ABSTRACT: Objectives: Edentulism and use of complete dentures (CD), which are common among elderly people, increase the risk for malnutrition and weight loss, components of frailty syndrome. Objectives: To identify if CD use is associated with the presence of frailty in a group of edentulous people aged ≥70 years, residing in Mexico City. Design: This was a cross-sectional analysis of baseline data of a cohort study. Setting and Participants: The study population consisted of 33,347 people living independently in one district of Mexico City, 149 edentulous subjects were interviewed and examined for this analysis. Measurements: Frail people experienced 3 or more of the following 5 components: unintentional weight loss, poor endurance and energy, low physical activity, slowness, and weakness. Dental variables were CD use, CD functionality, self-perception of oral health, use of dental services the previous year, xerostomia, and chewing problems. Age, sex, education level, cognitive impairment, urinary incontinence, number of falls, hospitalization, and number of drugs consumed were considered. Univariate analysis and a logistic regression model were used. Results: The prevalence of frailty was 23.5%. The probability of being frail increased among participants with osteoporosis (OR = 3.2), urinary incontinence (OR = 3.8), cognitive impairment (OR = 4.1), and non-use of CD (OR = 5.2); for each additional drug taken per day, the risk of frailty increased by 28.9%. Conclusions: The non-use of CD in edentulous older persons can be a risk marker for frailty, health evaluation of the elderly should include a dental assessment.


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