Frailty as an Outcome in Geriatrics Research: Not Ready for Prime Time?

Editorials6 March 2018Frailty as an Outcome in Geriatrics Research: Not Ready for Prime Time?Rebecca T. Brown, MD, MPH and Kenneth E. Covinsky, MD, MPHRebecca T. Brown, MD, MPHDivision of Geriatrics, University of California, San Francisco, and San Francisco VA Medical Center, San Francisco, California (R.T.B., K.E.C.) and Kenneth E. Covinsky, MD, MPHDivision of Geriatrics, University of California, San Francisco, and San Francisco VA Medical Center, San Francisco, California (R.T.B., K.E.C.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-3048 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Frailty, one of the key syndromes of aging, is defined as a state of decreased physiologic reserve and increased vulnerability to stressors, such as acute illness, injury, or surgery. During the past several decades, frailty has been increasingly recognized as a strong predictor of poor outcomes, including acute care use, disability, and death, in older adults (1). For this reason, developing interventions to prevent or delay frailty and its associated adverse outcomes is an emerging area of geriatrics research.Despite this growing focus, no single, universally accepted definition of frailty exists. Rather, several definitions are commonly used, each of which ...References1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381:752-62. [PMID: 23395245] doi:10.1016/S0140-6736(12)62167-9 CrossrefMedlineGoogle Scholar2. Rockwood K, Mitnitski A. Frailty in relation to the accumulation of deficits. J Gerontol A Biol Sci Med Sci. 2007;62:722-7. [PMID: 17634318] CrossrefMedlineGoogle Scholar3. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al; Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146-56. [PMID: 11253156] CrossrefMedlineGoogle Scholar4. Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14:392-7. [PMID: 23764209] doi:10.1016/j.jamda.2013.03.022 CrossrefMedlineGoogle Scholar5. Daniels R, Metzelthin S, van Rossum E, de Witte L, van den Heuvel W. Interventions to prevent disability in frail community-dwelling older persons: an overview. Eur J Ageing. 2010;7:37-55. [PMID: 28798616] doi:10.1007/s10433-010-0141-9 CrossrefMedlineGoogle Scholar6. Giné-Garriga M, Roqué-Fíguls M, Coll-Planas L, Sitjà-Rabert M, Salvà A. Physical exercise interventions for improving performance-based measures of physical function in community-dwelling, frail older adults: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2014;95:753-769. [PMID: 24291597] doi:10.1016/j.apmr.2013.11.007 CrossrefMedlineGoogle Scholar7. Cesari M, Vellas B, Hsu FC, Newman AB, Doss H, King AC, et al; LIFE Study Group. A physical activity intervention to treat the frailty syndrome in older persons-results from the LIFE-P study. J Gerontol A Biol Sci Med Sci. 2015;70:216-22. [PMID: 25387728] doi:10.1093/gerona/glu099 CrossrefMedlineGoogle Scholar8. Cameron ID, Fairhall N, Langron C, Lockwood K, Monaghan N, Aggar C, et al. A multifactorial interdisciplinary intervention reduces frailty in older people: randomized trial. BMC Med. 2013;11:65. [PMID: 23497404] doi:10.1186/1741-7015-11-65 CrossrefMedlineGoogle Scholar9. Trombetti A, Hars M, Hsu FC, Reid KF, Church TS, Gill TM, et al. Effect of physical activity on frailty. Secondary analysis of a randomized controlled trial. Ann Intern Med. 2018;168:309-16. doi:10.7326/M16-2011 LinkGoogle Scholar10. Pahor M, Guralnik JM, Ambrosius WT, Blair S, Bonds DE, Church TS, et al; LIFE study investigators. Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial. JAMA. 2014;311:2387-96. [PMID: 24866862] doi:10.1001/jama.2014.5616 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Division of Geriatrics, University of California, San Francisco, and San Francisco VA Medical Center, San Francisco, California (R.T.B., K.E.C.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-3048.Corresponding Author: Rebecca T. Brown, MD, MPH, San Francisco VA Medical Center, 4150 Clement Street, VA Box 181G, San Francisco, CA 94121; e-mail, rebecca.[email protected]edu.Current Author Addresses: Drs. Brown and Covinsky: San Francisco VA Medical Center, 4150 Clement Street, VA Box 181G, San Francisco, CA 94121.This article was published at Annals.org on 9 January 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of Physical Activity on Frailty Andrea Trombetti , Mélany Hars , Fang-Chi Hsu , Kieran F. Reid , Timothy S. Church , Thomas M. Gill , Abby C. King , Christine K. Liu , Todd M. Manini , Mary M. McDermott , Anne B. Newman , W. Jack Rejeski , Jack M. Guralnik , Marco Pahor , Roger A. 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McDermott, MD, and Roger A. Fielding, PhDFrailty and Resilience as Outcome Measures in Clinical Trials and Geriatric Care: Are We Getting Any Closer? 6 March 2018Volume 168, Issue 5Page: 361-362KeywordsDisabilitiesDisclosureElderlyExerciseFrailtyGeriatricsMusclesQuality of lifeSafetySurgery ePublished: 9 January 2018 Issue Published: 6 March 2018 PDF downloadLoading ...