Network Physiology in Aging and Frailty: The Grand Challenge of Physiological Reserve in Older Adults

The ‘Bermuda Triangle’ of orthostatic hypotension, cognitive impairment and reduced mobility: prospective associations with falls and fractures in The Irish Longitudinal Study on Ageing

“…The combination of OH, cognitive impairment and MI has been labelled the Bermuda Triangle of Falls [ 21 , 22 ]. This study examines clustering of these three common geriatric syndromes, as well as the likelihood of falls related to these clusters, in a large, population-representative sample of community-dwelling older people.…”

“…A synergy between the factors can be explained by OH destabilising the underlying mobility impairment (MI), and cognitive impairment reducing prudential anticipation of the increased gait instability as well as impaired ability to appropriately react to the instability. This hypothesis was termed the ‘Bermuda Triangle’ of falls, representing physiological instability across three integrated systems, but this had yet to be demonstrated in a well-designed study [ 21 , 22 , 23 ]. The aim of this study was therefore to examine clustering of these three common geriatric syndromes—OH, cognitive and MI—and examine the longitudinal relationship between clusters of these syndromes and incident falls and fractures during an 8-year follow-up period.…”

Structural brain signatures of frailty, defined as accumulation of self-reported health deficits in older adults

“…From here, we went one step further and explored which FI deficits had the most important role in relation with neuroimaging biomarkers such as the cortex volume. The concept of network physiology emerged recently to highlight the fact that the functioning of different systems is interconnected ( Romero-Ortuño et al, 2021 ). For this reason, we decided to use a graph theory approach to explore the interconnection between cortex volume and each of the FI features.…”

Management of Elderly and Old Cancer Patients – Geriatric Oncology

“…11 As long as the concepts of longevity medicine are maturing and artificial intelligence (AI)-based precision oncology is at the inceptive state of entering the clinical routine, the concept of frailty versus fitness, the so-called ''Frailty syndrome'' , is gaining traction. 9,12,13 Identifying frail cancer patients, i.e., those with high susceptibility, low functional reserve and unstable homeostasis, leads to a better estimation of individual response to therapies than looking at chronological age alone, 9,13 therefore, careful consideration of each patient's status, including frailty in the treatment decision-making process is an integral part of oncological management. However, measuring and quantifying frailty in the real-world setting remains a challenge.…”

“…However, measuring and quantifying frailty in the real-world setting remains a challenge. 12 In addition to personal biological status, the optimal treatment in older cancer patients is challenged by the importance of maintaining quality of life (QoL). In routine clinical practice, the question often arises as to which treatment strategy is the right one for each patient, especially one that allows the patient to remain independent for as long as possible.…”