The degree of frailty as a translational measure of health in aging

Susan E. Howlett; Andrew D. Rutenberg; Kenneth Rockwood

doi:10.1038/s43587-021-00099-3

The degree of frailty as a translational measure of health in aging

Susan E. Howlett, Andrew D. Rutenberg, Kenneth Rockwood

Producción científica: Contribución a una revista › Artículo de revisión › revisión exhaustiva

185 Citas (Scopus)

Resumen

Frailty is a multiply determined, age-related state of increased risk for adverse health outcomes. We review how the degree of frailty conditions the development of late-life diseases and modifies their expression. The risks for frailty range from subcellular damage to social determinants. These risks are often synergistic—circumstances that favor damage also make repair less likely. We explore how age-related damage and decline in repair result in cellular and molecular deficits that scale up to tissue, organ and system levels, where they are jointly expressed as frailty. The degree of frailty can help to explain the distinction between carrying damage and expressing its usual clinical manifestations. Studying people—and animals—who live with frailty, including them in clinical trials and measuring the impact of the degree of frailty are ways to better understand the diseases of old age and to establish best practices for the care of older adults.

Idioma original	English
Páginas (desde-hasta)	651-665
Número de páginas	15
Publicación	Nature Aging
Volumen	1
N.º	8
DOI	https://doi.org/10.1038/s43587-021-00099-3
Estado	Published - ago. 2021

Nota bibliográfica

Funding Information:
We wish to acknowledge the influence of Arnold Mitnitski to how we think about frailty. Arnold died after a brief illness on 26 May 2021. We will miss him both as a friend and colleague, and one who has had an enormous influence on our field. Work in the laboratory of S.E.H. is supported the Canadian Institutes of Health Research (PJT 162462 and 155961) and the Heart and Stroke Foundation of Canada (G-19–0026260). Work in the laboratory of A.D.R. is supported by grants from the Natural Sciences and Engineering Research Council of Canada (RGPIN-2019–05888). Work in the Geriatric Medicine Research Unit (GMRU; K.R.) is supported by grants from the Canadian Institutes of Health Research (PJT 156114), Research Nova Scotia (RNS-SIG-2021–1640) and the Canadian Frailty Network (CFN-CSA-2019 and NSHA-2020). The GMRU has received long-term philanthropic support from the Fountain Family Innovation Fund of the QEII Health Sciences Foundation. The figures were created with BioRender.com.

Funding Information:
We wish to acknowledge the influence of Arnold Mitnitski to how we think about frailty. Arnold died after a brief illness on 26 May 2021. We will miss him both as a friend and colleague, and one who has had an enormous influence on our field. Work in the laboratory of S.E.H. is supported the Canadian Institutes of Health Research (PJT 162462 and 155961) and the Heart and Stroke Foundation of Canada (G-19–0026260). Work in the laboratory of A.D.R. is supported by grants from the Natural Sciences and Engineering Research Council of Canada (RGPIN-2019–05888). Work in the Geriatric Medicine Research Unit (GMRU; K.R.) is supported by grants from the Canadian Institutes of Health Research (PJT 156114), Research Nova Scotia (RNS-SIG-2021–1640) and the Canadian Frailty Network (CFN-CSA-2019 and NSHA-2020). The GMRU has received long-term philanthropic support from the Fountain Family Innovation Fund of the QEII Health Sciences Foundation. The figures were created with BioRender.com .

Funding Information:
K.R. has asserted copyright of the Clinical Frailty Scale through Dalhousie University’s Industry, Liaison and Innovation Office. Use is free for education, research and not-for-profit health care. Users agree not to change or commercialize the scale. In addition to academic and hospital appointments, K.R. is cofounder of Ardea Outcomes, which (as DGI Clinical) in the last 3 years has contracts with pharma and device manufacturers (Biogen, Hollister, Novartis, Nutricia, Roche and Takeda) on individualized outcome measurement. In 2019, K.R. was paid an honorarium for an interview with Biogen. In 2020, he attended an advisory board meeting with Nutricia on dementia, and chaired a scientific workshop and technical review panel on frailty for the Singapore National Research Foundation. Otherwise, any personal fees were for invited guest lectures, rounds and academic symposia, received directly from event organizers, for presentations on frailty. K.R. is associate director of the Canadian Consortium on Neurodegeneration in Aging, which is funded by the Canadian Institutes for Health Research, the Alzheimer Society of Canada and several other charities. S.E.H. has a paid consulting role with Ardea Outcomes. A.D.R. has no competing interests to declare.

Publisher Copyright:
© 2021, Springer Nature America, Inc.

ASJC Scopus Subject Areas

Ageing
Geriatrics and Gerontology
Neuroscience (miscellaneous)

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abstract = "Frailty is a multiply determined, age-related state of increased risk for adverse health outcomes. We review how the degree of frailty conditions the development of late-life diseases and modifies their expression. The risks for frailty range from subcellular damage to social determinants. These risks are often synergistic—circumstances that favor damage also make repair less likely. We explore how age-related damage and decline in repair result in cellular and molecular deficits that scale up to tissue, organ and system levels, where they are jointly expressed as frailty. The degree of frailty can help to explain the distinction between carrying damage and expressing its usual clinical manifestations. Studying people—and animals—who live with frailty, including them in clinical trials and measuring the impact of the degree of frailty are ways to better understand the diseases of old age and to establish best practices for the care of older adults.",

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The degree of frailty as a translational measure of health in aging

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ASJC Scopus Subject Areas

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