A Widely Accepted Definition Is Lacking
by Anna Mende, Dr. med. Ann-Kathrin Riegel, Dr. med. Lili Plümer, Dr. med. Cynthia Olotu, Prof. Dr. med. Alwin E. Goetz, and Prof. Dr. med. Rainer Kiefmann in issue 5/2019
In their interesting article, Mende et al. highlighted a very important and virtually unresolved issue in the diagnosis and management of frailty, i.e., the lack of a universally agreed definition for this condition (1). This concerning lack of harmonization may not only challenge or delay the diagnosis and treatment of frail individuals but, even more importantly, would create a major setback for identifying reliable predictive factors that would enable early and accurate stratification of subjects at higher risk of becoming frail.
The FRAILOMIC consortium, a vast research initiative aiming at identifying predictive factors of frailty and disability, has recently endorsed a practical definition of frailty, as an “age-associated syndrome, characterized by decreased biological reserve and resistance to stressors due to functional decline of several physiological systems, which places the individual at enhanced risk of disability, hospitalization and death” (2). This clear-cut definition not only appears inclusive of some essential psychological, social and cognitive factors, as clearly advised by Mende and colleagues, but can also be reliably used for establishing effective preventive measures. The concept of disability can in fact be translated into a clearly identifiable phenotypic picture, entailing a kaleidoscope of physiological, psychological, and social impairments resulting from progressive aging, change of lifestyle factors, incident diseases, and the multifaceted interaction among all these variables. I believe that the use of this definition will help harmonization in frailty research.
Prof. Giuseppe Lippi MD
Section of Clinical Biochemistry, University Hospital of Verona
Piazzale LA Scuro, 37134 Verona, Italy
|1.||Mende A, Riegel AK, Plümer L, Olotu C, Goetz AE, Kiefmann R: The determinants of perioperative outcome in frail older patients. Dtsch Arztebl Int 2019; 116: 73–82 VOLLTEXT|
|2.||Erusalimsky JD, Grillari J, Grune T, et al.: In search of ‚Omics‘-based biomarkers to predict risk of frailty and its consequences in older individuals: The FRAILOMIC Initiative. Gerontology 2016; 62: 182–90 CrossRef MEDLINE|