Frailty

German: Frailty

Synonym: Frailty-syndrome

1 Definition

In the medical context the term frailty is used to describe a geriatric syndrome. It presents with a general increase of susceptibility to exogenous stressors (overtaxing, restlessness, diseases, etc.) for older patients. Conversely it can be viewed as reduced resistance against stressors and their effects. Frailty is the result of both physiological processes of aging and its pathological consequenses.

2 Classification

In order to consider frailty to be present at least three of the following five symptoms have to be present:

• Unintentional weightloss, defined by the Deutschen Gesellschaft für Ernährung (German Society of Nutrition) as a >5% reduction of weight within 3 months or >10% reduction of weight within 6 months. ^[1]

• Decrease of the rough body strength (measured through hand strength)
• Subjective exhaustion
• Immobility, uncertainty of gait, unsteadiness
• General reduction of activity

3 Prevalence

Exact epidemiologic numbers are unknown.

4 Typical Diseases

Frailty can especially be expected to be present along with the following illnesses:

• Arterial hypertension
• Stroke
• Heart attack
• Diabetes mellitus

5 Pathophysiology

Frailty patients commonly present the following laboratory data findings:

• Increased levels of interleukin (IL-1, IL-6 and others), tumor necrosis factor (TNFα) and C-reactive protein (CRP and hCRP)
• Reduced levels of estrogen, testosterone, corticosteroids, growth hormones and didehydroepiandrosterones (DHEA)

6 Therapy

The therapy is centered around the reduction of the associated risk factors. A combination of strength training and coordinative exercises have been shown to be helpful. Also endurance training and healthy nutrition have been shown to reduce the risks. Optimal therapeutical management of already existing illnesses also helps to reduce the risk or effect of frailty.

7 Sources

1. ↑ [1] DGEM-Leitlinie Klinische Ernährung: Klinische Ernährung in der Geriatrie, 2013