Article

Research Agenda for Frailty in Older Adults: Toward a Better Understanding of Physiology and Etiology: Summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults

University of Pittsburgh, Pittsburgh, Pennsylvania, United States
Journal of the American Geriatrics Society (Impact Factor: 4.57). 07/2006; 54(6):991-1001. DOI: 10.1111/j.1532-5415.2006.00745.x
Source: PubMed

ABSTRACT

Evolving definitions of frailty, and improved understanding of molecular and physiological declines in multiple systems that may increase vulnerability in frail, older adults has encouraged investigators from many disciplines to contribute to this emerging field of research. This article reports on the results of the 2004 American Geriatrics Society/National Institute on Aging conference on a Research Agenda on Frailty in Older Adults, which brought together a diverse group of clinical and basic scientists to encourage further investigation in this area. This conference was primarily focused on physical and physiological aspects of frailty. Although social and psychological aspects of frailty are critically important and merit future research, these topics were largely beyond the scope of this meeting. Included in this article are sections on the evolving conceptualization and definitions of frailty; physiological underpinnings of frailty, including the potential contributions of inflammatory, endocrine, skeletal muscle, and neurologic system changes; potential molecular and genetic contributors; proposed animal models; and integrative, system biology approaches that may help to facilitate future frailty research. In addition, several specific recommendations as to future directions were developed from suggestions put forth by participants, including recommendations on definition and phenotype development, methodological development to perform clinical studies of individual-system and multiple-system vulnerability to stressors, development of animal and cellular models, application of population-based studies to frailty research, and the development of large collaborative networks in which populations and resources can be shared. This meeting and subsequent article were not meant to be a comprehensive review of frailty research; instead, they were and are meant to provide a more-targeted research agenda-setting process.

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Available from: Linda P Fried, Mar 08, 2015
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    • "Na associação das medidas antropométricas com fragilidade, observa-se que raros estudos têm se dedicado a este assunto. O que se vê na literatura é a associação do estado nutricional, magreza e obesidade, aspectos importantes no curso molecular, fisiológico e clínico da fragilidade[8]. Mesmo sem a possibilidade de comparação das diversas medidas antropométricas avaliadas em nosso estudo, pela falta de estudos similares na literatura, o comportamento dessas medidas em relação aos estágios de fragilidade permite que se possa associar as características das medidas aos conceitos da síndrome fragilidade. A diminuição da estatura e da altura do joelho (medidas de compleição física), a cada estágio de fragilidade, está congruente com a conceituação de fragilidade como um distúrbio de desperdício, ou seja, um estado de diminuição de reservas e declínio cumulativo de diversos sistemas fisiológicos[4,83]. "

    Preview · Article · Jan 2016 · Scientia Medica
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    • "Clinical condition of frailty is the most problematic expression of aging. Frailty is a state of increased vulnerability to poor resolution of homoeostasis after a stressor event, which increases the risk of adverse outcomes, including falls, delirium, and disability (Eeles et al., 2012; Fried et al., 2001; Walston et al., 2006). This state is due to a disorder of several interrelated physiological systems. "
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    ABSTRACT: The rapid growth in the number of older adults has many implications for public health, including the need to better understand the risks posed by environmental exposures. Aging leads to a decline and deterioration of functional properties at the cellular, tissue and organ level. This loss of functional properties yields to a loss of homeostasis and decreased adaptability to internal and external stress. Frailty is a geriatric syndrome characterized by weakness, weight loss, and low activity that is associated with adverse health outcomes. Frailty manifests as an age-related, biological vulnerability to stressors and decreased physiological reserves. Ambient air pollution exposure affects human health, and elderly people appear to be particularly susceptible to its adverse effects. The aim of this paper is to discuss the role of air pollution in the modulation of several biological mechanisms involved in aging. Evidence is presented on how air pollution can modify the bidirectional association between successful and pathological aging throughout the frailty conditions.
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    • "It is well-known that the phenotype of the frailty syndrome in the elderly is identified according to the presence of at least three of the following criteria: self-reported unintentional weight loss, self-reported fatigue, directly measured low grip strength, self-reported low physical activity, and directly measured low gait speed [12]. Such patients are more vulnerable to adverse clinical outcomes such as falls, the risk of hospitalization, and death [13]. "
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    ABSTRACT: This paper presents an algorithm that applies metrics derived from automatic QRS detection and segmentation in electrocardiogram signals for analyzing Heart Rate Variability to study the evolution of metrics in the frequency domain of a clinical procedure. The analysis was performed on three sets of elderly people, who are categorized according to frailty phenotype. The first set was comprised of frail elderly, the second pre-frail elderly, and the third robust elderly. Investigators from many disciplines have been encouraged to contribute to the understanding of molecular and physiological changes in multiple systems that may increase the vulnerability of frail elderly. In this work, the frailty phenotype can be characterized by unintentional weight loss, as self-reported, fatigue assessed by self-report, grip strength (measured directly), physical activity level assessed by self-report and gait speed (measured). The results obtained demonstrate the existence of significant differences between Heart Rate Variability metrics for the three groups, especially considering a higher preponderance for sympathetic nervous system for the group of robust patients in response to postural maneuver.
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