Fight Aging!

Frailty is an end stage of aging, characterized by physical weakness, chronic inflammation, and lack of robustness in response to challenges. Frail individuals tend to spiral downward into organ failure and death in response to adverse circumstances, such as infection or injury, that less frail, younger individuals can survive. The question of how to reverse frailty is an important one; in principle, a good enough way of addressing the underlying causative mechanisms of aging would lead to improvement in patient outcomes. A number of the groups involved in development of first generation age-slowing and rejuvenating therapies are looking to frailty as a target for initial clinical trials.

Frailty is a multi-dimensional and dynamic condition, theoretically defined as "a state of increased vulnerability, resulting from age-associated declines in reserve and function across multiple physiologic systems, such that the ability to cope with every day or acute stressors is compromised". Although declines in physiological reserve are associated with senescence in the normal ageing process, frailty is an extreme consequence of this process, where this decline is accelerated and homeostatic responses begin to fail.

Frailty is a common and clinically significant condition among older adults. This is predominantly due to its association with adverse health outcomes, such as hospitalisation, falls, disability, and mortality. All older adults are susceptible to the risk of developing frailty, and even their younger counterparts. However, this risk is significantly increased with increases in chronological age, in the presence of comorbidities, low physical activity, poor dietary intake, and low-socioeconomic status, among a number of other factors.

While frailty is a dynamic condition, with the possibility of bi-directional transition between frailty states, this transition is more commonly progressive. This is largely due to the association of frailty with a plethora of adverse health outcomes, which can often lead to a spiral of decline. As frailty progresses, interventions to mitigate, manage, or reverse this decline become increasingly difficult to implement, both from practical and physiological perspectives.

The relative prevalence of frailty in older adults may be reduced with future improvements in treatment, particularly those identified as effective at mitigating the onset of frailty. However, irrespective of this, the absolute prevalence, and overall burden of frailty is projected to increase dramatically in the coming decades as the population ages. Perhaps of most concern in this regard, is that several longitudinal birth cohort studies have reported increases in the relative prevalence of frailty among more contemporary generations of older adults, when compared to their generational predecessors.

Link: https://doi.org/10.1159/000528561