Frailty and Primary Sarcopenia: A Review

Abstract

Increasing longevity, coupled with rising frailty and sarcopenia of aging, significantly affects function and quality of life of older adults. This review discusses the definition, assessment, and management of frailty and sarcopenia, and examines the relationship between them. Medline, Scopus and Psychoinfo databases were searched using the keywords frailty, sarcopenia, aging, and functional disability. The findings are that frailty and sarcopenia are often assessed clinically with such methods such as DeXA, CT scan, MRI, bioelectrical impedance, or anthropometry. Frailty and sarcopenia differentially affect older adults. Both conditions are characterized by decreased energy reserves and resistance to external and internal stressors, resulting in susceptibility to fatigue, comorbidity, sedentary life style, functional decline, hospitalization, quality of life, and even death. The estimated prevalence of frailty with sarcopenia is relatively low; however, the condition requires early detection and careful management.

Oxidative Stress, Telomere Shortening, and Apoptosis Associated to Sarcopenia and Frailty in Patients with Multimorbidity

“…It was also associated to a significant telomere length shortening compared to other PP without frailty. The deep relation between sarcopenia and frailty is already known; they share molecular and physiological pathways, symptoms, signs, and clinical phenotypes [ 32 , 33 ], so the presence of these molecular alterations in both of them is biologically coherent. In this case, we also observed a decreased antioxidant fitness of the plasma in frail PP.…”

Relationship between a three-month physical conditioning “posture-balance-motricity and health education” (PBM-HE) program on postural and balance capacities of sedentary older adults: influence of initial motor profile

“…Cesari et al (2018) considered that “functional ability is determined by the intrinsic capacity (physical and mental) and in reference of the International Classification of Functioning, Disability and Health (ICF) framework, five domains (i.e, locomotion, vitality, cognition, psychological, sensory) are pivotal for capturing the individual’s intrinsic ability and therefore also reserves”. This preoccupation with individual functional reserves serves the prevention of frailty, and various works seek the validation of tools for screening for clinical signs of significant decrease in functional ability [ 32 , 35 , 37 , 63 ]. The identification of reserves could also serve the rehabilitation of people with loss of autonomy and help in the definition of physical reconditioning planning models, taking into account the initial level and also the ability to progress.…”

“…In addition to the analysis of the potential improvement of the balancing capacities, whatever the age, another concern consists of the functional reserves available to the person and which partially justify measured progress. This present question in the field of learning and cognitive science also applies to the aging sector and refers to notions of adaptation and frailty [ 32 , 33 ]. Some studies describe the fragility of the elderly person in various physiological, psychological or neuro-cognitive domains and identify markers such as walking to determine the health and future of the person [ 34 – 37 ].…”

Physical Therapy for Neurological Conditions in Geriatric Populations

“…The PT is part of an interdisciplinary team targeted to prevent functional decline, restore function, and ADL, prevent secondary complications and comorbidities, allow compensating to offset and adapt to residual disabilities, and to maintain of function over the long term. The prevention of falls, frailty, fatigue, and sarcopenia could improve the patient’s health and life span ( 9 , 10 ). PT for neurological patients also has a role in immediate or acute care, when there is a requirement to provide hospital-based short-term intensive PT aimed at the recovery of musculoskeletal and neurological function, limbs positioning, and handling due to hypertonic or spastic muscles ( 11 ).…”