Frailty syndrome: an overview.
Frailty syndrome: an overview.
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DOI：
10.2147/cia.s45300
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发表时间：
2014
影响因子：
3.6
通讯作者：
Leng SX
中科院分区：
文献类型：
--
作者：
Chen X;Mao G;Leng SX
虚弱是一种常见且重要的老年综合征，其特征在于与年龄相关的多器官系统生理储备和功能下降，导致对不良健康结果的脆弱性增加。文献中描述了两种主要的脆弱模型。虚弱表型将虚弱定义为满足五个表型标准中的三个或更多个的独特临床综合征：虚弱，缓慢，低水平的体力活动，自我报告的疲惫和无意的体重减轻。虚弱指数将虚弱定义为综合老年评估中确定的累积缺陷。最近在理解虚弱的发病机制方面取得了重大进展。慢性炎症可能是一个关键的病理生理过程，直接或间接通过其他中间生理系统，如肌肉骨骼，内分泌和血液系统，有助于虚弱综合征。虚弱的复杂多因素病因还包括肥胖和特定疾病。主要的临床应用包括风险评估和分层。这可以适用于社区和各种护理环境中的老年人口。虚弱也可能是有用的风险评估手术患者和那些与心血管疾病，癌症，或人类免疫缺陷病毒感染，以及评估疫苗的有效性在老年人。目前，运动和综合性老年医学跨学科评估和治疗是虚弱的关键干预措施。随着对脆弱的生物学基础和复杂性的进一步了解，可能会开发出更有效和更有针对性的干预策略和创新的老年护理模式。
Frailty is a common and important geriatric syndrome characterized by age-associated declines in physiologic reserve and function across multiorgan systems, leading to increased vulnerability for adverse health outcomes. Two major frailty models have been described in the literature. The frailty phenotype defines frailty as a distinct clinical syndrome meeting three or more of five phenotypic criteria: weakness, slowness, low level of physical activity, self-reported exhaustion, and unintentional weight loss. The frailty index defines frailty as cumulative deficits identified in a comprehensive geriatric assessment. Significant progress has recently been made in understanding the pathogenesis of frailty. Chronic inflammation is likely a key pathophysiologic process that contributes to the frailty syndrome directly and indirectly through other intermediate physiologic systems, such as the musculoskeletal, endocrine, and hematologic systems. The complex multifactorial etiologies of frailty also include obesity and specific diseases. Major clinical applications include risk assessment and stratification. This can be applied to the elderly population in the community and in a variety of care settings. Frailty may also be useful for risk assessment in surgical patients and those with cardiovascular diseases, cancer, or human immunodeficiency virus infection, as well as for assessment of vaccine effectiveness in older adults. Currently, exercise and comprehensive geriatric interdisciplinary assessment and treatment are key interventions for frailty. As understanding of the biologic basis and complexity of frailty further improves, more effective and targeted interventional strategies and innovative geriatric-care models will likely be developed.