Frailty, Sarcopenia, Falls and Fractures

Abstract

Frailty is a multidimensional phenomenon of increased vulnerability to the challenge of an acute illness, injury or social crisis. It overlaps with but is distinct from multi-morbidity and disability. Frailty is age related but highly variable between older individuals and more prevalent in women. There are several diagnostic definitions and measures of frailty, and different tools are suitable for different contexts. Frailty is modifiable through multicomponent interventions including exercise and nutritional optimisation. The two main physiological components are sarcopenia and cognition. Sarcopenia is age associated decline in muscle mass and function. Falls occur in about one third of individuals aged 65 plus each year. The majority of falls in older people are associated with frailty and multicomponent impairments, particularly of muscle function, balance and cognition. Falls are therefore regarded as one of the geriatric syndromes. The most effective preventative intervention is multicomponent approach including exercise. Most fragility fractures are related to falls. Frailty and falls risk is as important as bone health in prevention and management.