Abstract
Frailty is a clinical syndrome caused by homeostasis imbalance. It is characterized by marked vulnerability to endogenous or exogenous stressors, reduced self-care ability, and increased mortality risk. This aging-related syndrome is common in individuals older than 65 years and carries an increased risk for poor health outcomes. These include falls, incident disability, incapacity, and mortality. In addition, it can result in a poor prognosis for other comorbidities. With the aging population, frailty increases the burden of adverse health outcomes. Studies on frailty are at their infancy. In addition, there is a lack of thorough understanding of its pathogenesis. Several studies have suggested that frailty is caused by chronic inflammation due to enhanced intestinal permeability following gut microbiota imbalance as well as pathogen-related antibodies entering the circulation system. These result in musculoskeletal system disorders and neurodegenerative diseases. However, this assumption has not been validated in large cohort-based studies. Several studies have suggested that inflammation is not the only cause of frailty. Hence, further studies are necessary to extend our understanding of its pathogenesis. This review summarizes the research findings in the field and expands on the possible role of the gut microbiota in frailty syndrome.
Highlights
Frailty is a clinical syndrome caused by homeostasis imbalance
A large population-based study on frailty demonstrated a decrease in symbiotic bacteria abundance and bacterial diversity and increased levels of pathogenic streptococci in the intestinal tract of patients taking pump inhibitors (PPIs). These results were validated in a study on fraternal twins taking PPIs [40]. These findings are of clinical significance because it proves that the use of PPIs and alterations in the gut microbiota were related to Clostridium difficile infection (CDI)
Previous studies have suggested that gut microbiota imbalance may be a cause of frailty
Summary
Frailty syndrome has been highly associated with age. A meta-analysis [3] based on 21 studies demonstrated that the incidence rate of frailty syndrome ranges between 4 and 59.1% and is positively correlated with age. Along with increased longevity and the higher proportion of the elderly in the population, the number of individuals with frailty syndrome keeps increasing [4]. Understanding the pathogenesis and prevention of frailty may lower the burden of adverse health outcomes in the elderly. It is an important public health concern to understand the cause and pathogenesis of frailty
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