Editorial: Something About Frailty

Abstract

{\rtf1\ansi\deff0\deftab254{\fonttbl{\f0\fnil\fcharset0 Arial;}{\f1\fnil\fcharset0 Times New Roman;}}{\colortbl\red0\green0\blue0;\red255\green0\blue0;\red0\green128\blue0;\red0\green0\blue255;\red255\green255\blue0;\red255\green0\blue255;\red128\green0\blue128;\red128\green0\blue0;\red0\green255\blue0;\red0\green255\blue255;\red0\green128\blue128;\red0\green0\blue128;\red255\green255\blue255;\red192\green192\blue192;\red128\green128\blue128;\red0\green0\blue0;}\wpprheadfoot0\paperw12240\paperh15840\margl1880\margr1880\margt1440\margb1440\margh720\margf720{\*\pnseclvl1\pnucrm\pnstart1\pnhang\pnindent720{\pntxtb}{\pntxta{.}}} {\*\pnseclvl2\pnucltr\pnstart1\pnhang\pnindent720{\pntxtb}{\pntxta{.}}} {\*\pnseclvl3\pndec\pnstart1\pnhang\pnindent720{\pntxtb}{\pntxta{.}}} {\*\pnseclvl4\pnlcltr\pnstart1\pnhang\pnindent720{\pntxtb}{\pntxta{)}}} {\*\pnseclvl5\pndec\pnstart1\pnhang\pnindent720{\pntxtb{(}}{\pntxta{)}}} {\*\pnseclvl6\pnlcltr\pnstart1\pnhang\pnindent720{\pntxtb{(}}{\pntxta{)}}} {\*\pnseclvl7\pnlcrm\pnstart1\pnhang\pnindent720{\pntxtb{(}}{\pntxta{)}}} {\*\pnseclvl8\pnlcltr\pnstart1\pnhang\pnindent720{\pntxtb{(}}{\pntxta{)}}} {\*\pnseclvl9\pnlcrm\pnstart1\pnhang\pnindent720{\pntxtb{(}}{\pntxta{)}}} \endnhere\sectdefaultcl{\pard{\ql\li0\fi0\ri0\sb0\sl\sa0 \plain\f1\fs22\cf0 Frailty has been discussed as a precursor to functional deterioration and often involves decreases in social activity (which might be related to incontinence) and mobility, fear of falling and hip fracture, and increased risk for stroke. Causes of frailty include: \'93chronological age, genes, and previous education level\'94 (M698). \plain\f1\fs22\cf0\cb4 There seems to be four main intrinsic factors responsible for the pathogenesis of frailty: \'93sarcopenia [\'93melting of flesh\'94] and related metabolic pathogenic factors, atherosclerosis, cognitive impairment, and malnutrition\'94 (M698).\plain\f1\fs22\cf0 [next page describes these in detail, esp. loss of muscle mass] \plain\f1\fs22\cf0\cb4 Social factors are low income, low ed, & lack of societal social support. Sites for preventative intervention: \'93anorexia; inactivity, lack of exercise, and fear of falling; pain; diabetes mellitus; depression; and delirium\'94\plain\f1\fs22\cf0 (M698). \par \ql\li0\fi0\ri0\sb0\sl\sa0 \plain\f1\fs22\cf0 \par \ql\li0\fi0\ri0\sb0\sl\sa0 \plain\f1\fs22\cf0 Sarcopenia brings a dec in ratio of skeletal muscle to adipose tissue free body mass. (1) Maintenance of fat free mass has been asssoc'd w/ genetic factors and perhaps mitochondria enzyme activity [which would mean it is related to the mother]. In men (possibly women, too), dec in testosterone might be related to loss of muscle mass; testosterone replacement might be effective Tx, but GH doesn't seem to be a suitable Tx due to inc'd mortality and free radical damage to muscle. Due to pain of Sar, Tx pain can help older persons to continue to exercise & Fx to help w/ muscle mass. (2) Sarcopenia also been related to effect of inc'd cytokines (esp. interleukin-6) on muscle, which contributes to lowered protein synthesis. Effects of immobility and lack of exercise from sarcopenia is big.\par \ql\li0\fi0\ri0\sb0\sl\sa0 \plain\f1\fs22\cf0 \par \ql\li0\fi0\ri0\sb0\sl\sa0 \plain\f1\fs22\cf0 (How atherosclerosis affects muscle mass and is a \'93prime etiological factor\'94 in frailty discussed top of M700. Role of vitamin deficits from malnutrition in cognitive impairment and atherosclerosis.)\par \ql\li0\fi0\ri0\sb0\sl\sa0 \plain\f1\fs22\cf0 }} }