Abstract
Frailty is a state that encompasses losses in physical, psychological or social domains. Therefore, frail people demonstrate a reduced potential to manage external stressors and to respond to life incidents. Consequently, such persons are prone to various adverse consequences such as falls, cognitive decline, infections, hospitalization, disability, institutionalization, and death. Pre-frailty is a condition predisposing and usually preceding the frailty state. Early detection of frailty (i.e., pre-frailty) may present an opportunity to introduce effective management to improve outcomes. Exercise training appears to be the basis of such management in addition to periodic monitoring of food intake and body weight. However, various nutritional supplements and other probable interventions, such as treatment with vitamin D or androgen, require further investigation. Notably, many societies are not conscious of frailty as a health problem. In fact, people generally do not realize that they can change this unfavorable trajectory to senility. As populations age, it is reasonable to begin treating frailty similarly to other population-affecting disorders (e.g., obesity, diabetes or cardiovascular diseases) and implement appropriate preventative measures. Social campaigns should inform societies about age-related frailty and pre-frailty and suggest appropriate lifestyles to avoid or delay these conditions. In this article, we review current information concerning therapeutic interventions in frailty and pre-frailty and discuss whether a greater public awareness of such conditions and some preventative and therapeutic measures may decrease their prevalence.
Highlights
Frailty is a geriatric syndrome caused by a multisystem decrease in reserve capability and is associated with a high risk for various adverse outcomes
We review up-to-date information concerning therapeutic interventions in frailty and pre-frailty and discuss whether a greater public awareness of these entities and some preventative and therapeutic measures may reduce their prevalence
Detection of any form of functional degradation in elderly subjects is critical for timely intervention to preserve their biological, psychological and social status
Summary
Frailty is a geriatric syndrome caused by a multisystem decrease in reserve capability and is associated with a high risk for various adverse outcomes. The multidimensional approach to frailty is based on an analysis of interactions among various domains: physical, psychological and social (Walston et al, 2006; Abellan van Kan et al, 2008, 2010; Gobbens et al, 2010b) In this context, frailty is considered a state affecting people who present losses in one or more of these levels of human functioning (Mitnitski et al, 2001; Rockwood et al, 2005, 2007; Searle et al, 2008; Gobbens et al, 2010a). Obesity modifies the effects of testosterone on frailty in females but not in males (Carcaillon et al, 2012) The accumulation of these subclinical conditions may appear as pre-frailty states, which, in addition to other comorbidities and older age, may increase the risk of () cardiovascular diseases (Flint, 2015).
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