The Frailty Syndrome: Clinical measurements and basic underpinnings in humans and animals

Mohler, M. Jane; Fain, Mindy J.; Wertheimer, Anne M.; Najafi, Bijan; Nikolich‐Žugich, Janko

doi:10.1016/j.exger.2014.01.024

Cited by 80 publications

(67 citation statements)

References 84 publications

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“…The FI is associated with an increased risk of institutionalization, disability, and all-cause mortality at all ages, especially in older people Clegg et al 2013;Mohler et al 2014). In adults, the metabolic syndrome is associated with significantly increased risk of cardiovascular disease (CVD), type 2 diabetes, and both cardiovascular and all-cause mortality (Lakka et al 2002;Meigs et al 2003;Hu et al 2004;McNeill et al 2005;Sattar et al 2008).…”

Section: Introductionmentioning

confidence: 99%

The association between frailty, the metabolic syndrome, and mortality over the lifespan

et al. 2017

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Frailty and the metabolic syndrome are each associated with poor outcomes, but in very old people (90+ years) only frailty was associated with an increased mortality risk. We investigated the relationship between frailty, metabolic syndrome, and mortality risk, in younger (20-65 years) and older (65+ years) people. This is a secondary analysis of the US National Health and Nutrition Examination Survey (NHANES) datasets for 2003-2004 and 2005-2006, linked with mortality data up to 2011. The metabolic syndrome was defined using the International Diabetes Federation criteria. Frailty was operationalized using a 41-item frailty index (FI). Compared to the younger group (n = 6403), older adults (n = 2152) had both a higher FI (0.10 ± 0.00 vs. 0.22 ± 0.00, p < 0.001) and a greater prevalence of the metabolic syndrome (24.1 vs. 45.5%, p < 0.001). The metabolic syndrome and FI were correlated in younger people (r = 0.25, p < 0.001) but not in older people (r = 0.08, p < 0.1). In bivariate analyses, the FI predicted mortality risk in both age groups whereas the metabolic syndrome did so only in the younger group. In Cox models, adjusted for age, sex, race, education, and each other, the FI was associated with increased mortality risk at both ages (younger HR 1.05 (1.04-1.06); older HR 1.04 (1.03-1.04) whereas the metabolic syndrome did not contribute to mortality risk. The FI better predicted mortality than did the metabolic syndrome, regardless of age.

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Section: Introductionmentioning

confidence: 99%

The association between frailty, the metabolic syndrome, and mortality over the lifespan

et al. 2017

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“…In mice models, disruption of the GH/IGF-1 signaling network resulting in IGF-1 reduction is associated with increase in oxidative stress in the liver, reduced lifespan, and reduced skeletal density [21]. In humans, low IGF-1 levels have been associated with frailty and decreased functionality [22] Although these candidate ageing/frailty biomarkers have been described in the geriatric field, their value in the clinical practice is far from established, and they have not formally been correlated with the frailty syndrome [23] in older cancer patients. The present study was undertaken to validate the five potential ageing/frailty markers mentioned above in a retrospective cohort of older breast cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Biological ageing and frailty markers in breast cancer patients

Brouwers

Dalmasso

Hatse

et al. 2015

Aging

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Older cancer patients are a highly heterogeneous population in terms of global health and physiological reserves, and it is often difficult to determine the best treatment. Moreover, clinical tools currently used to assess global health require dedicated time and lack a standardized end score. Circulating markers of biological age and/or fitness could complement or partially substitute the existing screening tools. In this study we explored the relationship of potential ageing/frailty biomarkers with age and clinical frailty. On a population of 82 young and 162 older non-metastatic breast cancer patients, we measured mean leukocyte telomere length and plasma levels of interleukin-6 (IL-6), regulated upon activation, normal T cell expressed and secreted (RANTES), monocyte chemotactic protein 1 (MCP-1), insulin-like growth factor 1 (IGF-1). We also developed a new tool to summarize clinical frailty, designated Leuven Oncogeriatric Frailty Score (LOFS), by integrating GA results in a single, semi-continuous score. LOFS' median score was 8, on a scale from 0=frail to 10=fit. IL-6 levels were associated with chronological age in both groups and with clinical frailty in older breast cancer patients, whereas telomere length, IGF-1 and MCP-1 only correlated with age. Plasma IL-6 should be further explored as frailty biomarker in cancer patients.

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“…It is widely thought that the most important influences associated with the aetiology include, but not limited to, a reduction of anabolic hormones (testosterone, growth hormone, insulin-like growth factor-I (IGF-I)), muscular disuse, increased circulating concentrations of pro-inflammatory cytokines (particularly TNF-α and IL-6), oxidative stress due to the accumulation of free radicals, mitochondrial dysregulation of muscle cells, a decline in the number of α-motoneurons and low vitamin-D status [100][101][102][103][104]. Although a number of dietary interventions have previously been investigated for their efficacy in the management and/or prevention of physical frailty and sarcopenia [45][46][47][48][49], the role of dietary protein often receives much attention.…”

Section: Underlying Mechanisms Underpinning the Potential Benefits Ofmentioning

confidence: 99%

Mediterranean Diet attenuates risk of frailty and sarcopenia: New insights and future directions

McClure

Villani

2017

JCSM Clinical Reports

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Sarcopenia and physical frailty are associated with progressive disability and predictive of negative health outcomes. Dietary interventions are considered the cornerstone in the management of sarcopenic symptomology and physical frailty. However few studies have investigated preventative strategies. Moreover, most studies have focused on the efficacy of individual nutrients or supplements rather than dietary patterns. The Mediterranean Diet (MedDiet) is a dietary pattern that provides evidence for an association between diet quality, healthy ageing and disease prevention. The purpose of this paper was to examine, synthesise and develop a narrative review of the current literature, investigating the potential benefits associated with adherence to a MedDiet and attenuation of physical frailty and sarcopenic symptomology in older adults. We also explored the underlying mechanisms underpinning the potential benefits of the MedDiet on ameliorating physical frailty and sarcopenic symptomology. Synthesis of the reviewed literature is suggestive of a decreased risk of physical frailty and sarcopenic symptomology with greater adherence to a MedDiet. We identified the anti-inflammatory and high antioxidant components of the MedDiet as two potential biological mechanisms involved. Due to a lack of evidence from RCTs to support the proposed physiological mechanisms, we suggest investigating these observations in older adults with type 2 diabetes (T2DM) whom are vulnerable to physical frailty and disability. A number of biological mechanisms describing the pathway to disability in older adults with T2DM have been postulated with many of these mechanisms potentially mitigated with dietary interventions involving the MedDiet. Exploring these mechanisms with the use of well-designed, longer-term dietary intervention studies in older adults with an increased vulnerability to physical frailty and sarcopenia is warranted.

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The Frailty Syndrome: Clinical measurements and basic underpinnings in humans and animals

Cited by 80 publications

References 84 publications

The association between frailty, the metabolic syndrome, and mortality over the lifespan

The association between frailty, the metabolic syndrome, and mortality over the lifespan

Biological ageing and frailty markers in breast cancer patients

Mediterranean Diet attenuates risk of frailty and sarcopenia: New insights and future directions

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