Frailty is a Medical Condition
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Somewhere lurking in the roots of medical progress is the urge to declare portions of degenerative aging to be medical conditions. At one point all degeneration was accepted as an inevitable part of the inevitable process of aging - a matter of "it is what it is." Then dementia was declared a condition, and then heart disease, and so on through the presently accepted set of age-related diseases. These have been split off from aging and declared to be treatable.

The division between named diseases of aging and aging is artificial, nothing more than taxonomy. Eventually there will be no aging in the popular eye, just a very long laundry list of medical conditions. This is the way it should be, because aging is just a very long laundry list of medical conditions, caused by known forms of underlying damage that are open to treatment and repair. The more that this is accepted, the more support there will be for research and development of rejuvenation treatments.

As a medical resident 30 years ago, Ava Kaufman remembers puzzling over some of the elderly patients who came to the primary-care practice at George Washington University Hospital. They weren't really ill, at least not with any identifiable diseases. But they weren't well, either. They were thin and weak. They had no energy. They tired easily. Their walking speed was agonizingly slow. "We couldn't put our finger on a specific diagnosis or problem,'' Kaufman says. "We didn't have a word for it then.''

Today we do. It's called frailty. There have always been frail people, but only in recent years has the term "frailty" become a medical diagnosis, defined by specific symptoms and increasingly focused on by those who deal with the medical issues of the elderly. Clinicians now are looking at ways to prevent or delay frailty, sometimes even reverse it. "Frailty is not an age, it's a condition," says Kaufman, a Bethesda internist and geriatrician. "We know it when we see it, and it's always been with us."


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