Frailty as a Nexus Between the Biology of Aging, Environmental Conditions and Clinical Geriatrics
Public Health Reviews volume 32, pages 475–488 (2010)
Abstract
Chronic diseases often determine pathologic phenotypes similar to those traditionally attributed to aging, such as accelerated decline of muscle mass and increments of basic metabolic rate, suggesting that the true nature of aging is progressively increasing entropy in the face of failing homeostatic mechanisms. Aging in different animal species and in humans suggest that increasing entropy causes major problems in four domains; body composition, energetic imbalance between availability and demand, homeostatic dysregulation, and neurodegeneration. In humans, loss of integrity and function in these domains causes manifestations similar to frailty, especially if the damage is severe and/or involves multiple domains, and has catastrophic consequences, such as physical and cognitive disability. Characterizing these phenotypes, and understanding the mechanisms by which they emerge with increasing entropy is a necessary step to find interventions that can prevent, delay or moderate the effects of aging. Pharmacological and non-pharmacological interventions that may effectively modulate the aging phenotypes are actively studied and will certainly be ready in the near future. Until then, creating a “senior friendly society”, that allows maximal independence but also promotes an active and healthy lifestyle may be the most cost-effective intervention to improve the quality of life in the population.
References
Louria DB. Extraordinary longevity: Individual and societal issues. J Am Geriatr Soc. 2005;53:S317–9.
Anderson GF, Hussey PS. Population aging: A comparison among industrialized countries. Health Aff (Millwood). 2000;19:191–203.
Walston J, Hadley EC, Ferrucci L, Guralnik JM, Newman AB, Studenski SA, et al. 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. J Am Geriatr Soc. 2006;54:991–1001.
Glass D, Roubenoff R. Recent advances in the biology and therapy of muscle wasting. Ann N Y Acad Sci. 2010;1211:25–36.
Ruggiero C, Metter EJ, Melenovsky V, Cherubini A, Najjar SS, Ble A, et al. High basal metabolic rate is a risk factor for mortality: The Baltimore Longitudinal Study of Aging. J Gerontol A Biol Sci Med Sci. 2008;63:698–706.
Kipling D, Davis T, Ostler EL, Faragher RG. What can progeroid syndromes tell us about human aging? Science. 2004;305:1426–31.
Ershler WB, Ferrucci L, Longo DL. Hutchinson-Gilford progeria syndrome. N Engl J Med. 2008;358:2409–10.
Bergman H, Ferrucci L, Guralnik J, Hogan DB, Hummel S, Karunananthan S, Wolfson C. Frailty: An emerging research and clinical paradigm—issues and controversies. J Gerontol A Biol Sci Med Sci. 2007;62:731–7.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: Evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–56.
Fried LP, Xue QL, Cappola AR, Ferrucci L, Chaves P, Varadhan R, et al. Nonlinear multisystem physiological dysregulation associated with frailty in older women: Implications for etiology and treatment. J Gerontol A Biol Sci Med Sci. 2009;64:1049–57.
Fried LP, Hadley EC, Walston JD, Newman AB, Guralnik JM, Studenski S, et al. From bedside to bench: Research agenda for frailty. Sci Aging Knowledge Environ. 2005;2005(31):pe24.
Bandeen-Roche K, Xue QL, Ferrucci L, Walston J, Guralnik JM, Chaves P, et al. Phenotype of frailty: Characterization in the women’s health and aging studies. J Gerontol A Biol Sci Med Sci. 2006;61:262–6.
Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clin Geriatr Med. 2011;27:17–26.
Rockwood K, Hubbard R. Frailty and the geriatrician. Age Ageing. 2004;33:429–30.
Ferrucci L, Bandinelli S, Cavazzini C, Lauretani F, Corsi A, Bartali B, et al. Neurological examination findings to predict limitations in mobility and falls in older persons without a history of neurological disease. Am J Med. 2004;116:807–15.
JW Rowe and RL Kahn. Human aging: Usual and successful. Science 1987;237:143–149.
Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric syndromes: Clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc. 2007;55:780–91.
Tinetti ME, Inouye SK, Gill TM, Doucette JT. Shared risk factors for falls, incontinence, and functional dependence. Unifying the approach to geriatric syndromes. JAMA. 1995;273:1348–53.
Young J, Inouye SK. Delirium in older people. BMJ. 2007;334:842–6.
Gems D, Partridge L. Stress-response hormesis and aging: “That which does not kill us makes us stronger”. Cell Metab. 2008;7:200–3.
Ferrucci L, Guralnik JM, Woodman RC, Bandinelli S, Lauretani F, Corsi AM, et al. Proinflammatory state and circulating erythropoietin in persons with and without anemia. Am J Med. 2005;118:1288.
Bongaarts J. Human population growth and the demographic transition. Philos Trans R Soc Lond B Biol Sci. 2009;364:2985–90.
Crimmins EM, Beltrán-Sánchez H. Mortality and morbidity trends: Is there compression of morbidity? J Gerontol B Psychol Sci Soc Sci. 2011;66:75–86.
Author information
Authors and Affiliations
Corresponding author
Additional information
Recommended Citation: Ferrucci L, Hesdorffer C, Bandinelli S, Simonsick EM. Frailty as a Nexus Between the Biology of Aging, Environmental Conditions and Clinical Geriatrics. Public Health Reviews. 2010;32:475–88.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.
The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Ferrucci, L., Hesdorffer, C., Bandinelli, S. et al. Frailty as a Nexus Between the Biology of Aging, Environmental Conditions and Clinical Geriatrics. Public Health Rev 32, 475–488 (2010). https://doi.org/10.1007/BF03391612
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03391612
Key words
- Frailty
- aging
- older adults