Frailty in Aging Adults : A Narrative Review

Frailty in Aging Adults : A Narrative Review

Tiffany Field, PhD

University of Miami/Miller School of Medicine and Fielding Graduate University

The recent literature (last five years) on frailty in aging (ageing) adults is predominantly focused on predictors/ risk factors for frailty along with some studies on negative effects and interventions. Aging has been typically defined as starting as early as 60 or 65. And, frailty has been defined as reduced physiological and functional reserve or measured by grip strength, weakness, exhaustion and social isolation or by longer assessments like The Frailty Index for Elders. The prevalence rates for frailty in aging adults have been highly variable in this literature, ranging from a low of 5% to a high of 51% depending on the severity of the frailty. Negative effects have included falls and mortality. Predictors/risk factors have included social isolation, lack of exercise, bad nutrition, anemia, anorexia, depression and multiple demographic variables. Interventions have included physical activity, Mediterranean-style diet, combinations of exercise and diet and the anti-aging drug metformin. Potential underlying mechanisms for frailty have been the negative effects of inflammation and the positive effects of Klotho, an aging suppressor gene. More well-designed longitudinal studies are needed as well as more robust randomized controlled trials.

Keywords: Frailty; Aging Adult; Narrative Review

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How to cite this article:

Tiffany Field. Frailty in Aging Adults : A Narrative Review. International Journal of Psychological Research and Reviews, 2023, 6:73. DOI: 10.28933/ijprr-2023-05-0803tf5

References

1. Álvarez-Bustos A, Carnicero-Carreño JA, Sanchez-Sanchez JL, Garcia-Garcia FJ, Alonso-Bouzón C, Rodríguez-Mañas L. Associations between frailty trajectories and frailty status and adverse outcomes in community-dwelling older adults. J Cachexia Sarcopenia Muscle. 2022 Feb;13(1):230-239. doi: 10.1002/jcsm.12888. Epub 2021 Dec 23. PMID: 34951157; PMCID: PMC8818602.
2. Aprahamian I, Borges MK, Hanssen DJC, Jeuring HW, Oude Voshaar RC. The Frail Depressed Patient: A Narrative Review on Treatment Challenges. Clin Interv Aging. 2022 Jun 22;17:979-990. doi: 10.2147/CIA.S328432. PMID: 35770239; PMCID: PMC9234191.
3. Araújo Carvalho AC, Tavares Mendes ML, da Silva Reis MC, Santos VS, Tanajura DM, Martins-Filho PRS. Telomere length and frailty in older adults-A systematic review and meta-analysis. Ageing Res Rev. 2019 Sep;54:100914. doi: 10.1016/j.arr.2019.100914. Epub 2019 Jun 3. PMID: 31170457.
4. Chen LY, Wu YH, Liu LK, Lee WJ, Hwang AC, Peng LN, Lin MH, Chen LK. Association Among Serum Insulin-Like Growth Factor-1, Frailty, Muscle Mass, Bone Mineral Density, and Physical Performance Among Community-Dwelling Middle-Aged and Older Adults in Taiwan. Rejuvenation Res. 2018 Jun;21(3):270-277. doi: 10.1089/rej.2016.1882. Epub 2017 May 9. PMID: 28351218.
5. El Assar M, Angulo J, Carnicero JA, Walter S, García-García FJ, Rodríguez-Artalejo F, Rodríguez-Mañas L. Association between telomere length, frailty and death in older adults. Geroscience. 2021 Apr;43(2):1015-1027. doi: 10.1007/s11357-020-00291-0. Epub 2020 Nov 15. PMID: 33190211; PMCID: PMC8110679.
6. Fan J, Yu C, Guo Y, Bian Z, Sun Z, Yang L, Chen Y, Du H, Li Z, Lei Y, Sun D, Clarke R, Chen J, Chen Z, Lv J, Li L; China Kadoorie Biobank Collaborative Group. Frailty index and all-cause and cause-specific mortality in Chinese adults: a prospective cohort study. Lancet Public Health. 2020 Dec;5(12):e650-e660. doi: 10.1016/S2468-2667(20)30113-4. PMID: 33271078; PMCID: PMC7708389.
7. Feart C. Nutrition and frailty: Current knowledge. Prog Neuropsychopharmacol Biol Psychiatry. 2019 Dec 20;95:109703. doi: 10.1016/j.pnpbp.2019.109703. Epub 2019 Jul 17. PMID: 31325470.
8. García-Peña C, Ramírez-Aldana R, Parra-Rodriguez L, Gomez-Verjan JC, Pérez-Zepeda MU, Gutiérrez-Robledo LM. Network analysis of frailty and aging: Empirical data from the Mexican Health and Aging Study. Exp Gerontol. 2019 Dec;128:110747. doi: 10.1016/j.exger.2019.110747. Epub 2019 Oct 25. PMID: 31665658; PMCID: PMC7493650.
9. Gonçalves RSDSA, Maciel ÁCC, Rolland Y, Vellas B, de Souto Barreto P. Frailty biomarkers under the perspective of geroscience: A narrative review. Ageing Res Rev. 2022 Nov;81:101737. doi: 10.1016/j.arr.2022.101737. Epub 2022 Sep 23. PMID: 36162706.
10. Huang WC, Huang YC, Lee MS, Chang HY, Doong JY. Frailty Severity and Cognitive Impairment Associated with Dietary Diversity in Older Adults in Taiwan. Nutrients. 2021 Jan 28;13(2):418. doi: 10.3390/nu13020418. PMID: 33525496; PMCID: PMC7911853.
11. Jang AR, Sagong H, Yoon JY. Frailty trajectory among community-dwelling middle-aged and older adults in Korea: evidence from the Korean Longitudinal Study of Aging. BMC Geriatr. 2022 Jun 25;22(1):524. doi: 10.1186/s12877-022-03229-7. PMID: 35752752; PMCID: PMC9233334.
12. Kamwa V, Welch C, Hassan-Smith ZK. The endocrinology of sarcopenia and frailty. Minerva Endocrinol (Torino). 2021 Dec;46(4):453-468. doi: 10.23736/S2724-6507.20.03198-3. Epub 2020 Dec 17. PMID: 33331737.
13. Lin H, Wang D, Ma S, Suo Y, Zhou P, Zhao Q, Liu J, Ding G. Frailty’s Prevalence and the Association with Aging-Related Health Conditions in Chinese Community Dwelling Elderly. Comput Intell Neurosci. 2022 Aug 16;2022:1748162. doi: 10.1155/2022/1748162. PMID: 36017459; PMCID: PMC9398729.
14. Lorenzi M, Bonassi S, Lorenzi T, Giovannini S, Bernabei R, Onder G. A review of telomere length in sarcopenia and frailty. Biogerontology. 2018 Jul;19(3-4):209-221. doi: 10.1007/s10522-018-9749-5. Epub 2018 Mar 16. PMID: 29549539.
15. Machón M, Mateo-Abad M, Vrotsou K, Zupiria X, Güell C, Rico L, Vergara I. Dietary Patterns and Their Relationship with Frailty in Functionally Independent Older Adults. Nutrients. 2018 Mar 24;10(4):406. doi: 10.3390/nu10040406. PMID: 29587356; PMCID: PMC5946191.
16. Mohammed I, Hollenberg MD, Ding H, Triggle CR. A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan. Front Endocrinol (Lausanne). 2021 Aug 5;12:718942. doi: 10.3389/fendo.2021.718942. PMID: 34421827; PMCID: PMC8374068.
17. Negm AM, Kennedy CC, Thabane L, Veroniki AA, Adachi JD, Richardson J, Cameron ID, Giangregorio A, Petropoulou M, Alsaad SM, Alzahrani J, Maaz M, Ahmed MM, Kim E, Tehfe H, Dima R, Sabanayagam K, Hewston P, Abu Alrob H, Papaioannou A. Management of Frailty: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials. J Am Med Dir Assoc. 2019 Oct;20(10):1190-1198. doi: 10.1016/j.jamda.2019.08.009. PMID: 31564464.
18. Ni Lochlainn M, Cox NJ, Wilson T, Hayhoe RPG, Ramsay SE, Granic A, Isanejad M, Roberts HC, Wilson D, Welch C, Hurst C, Atkins JL, Mendonça N, Horner K, Tuttiett ER, Morgan Y, Heslop P, Williams EA, Steves CJ, Greig C, Draper J, Corish CA, Welch A, Witham MD, Sayer AA, Robinson S. Nutrition and Frailty: Opportunities for Prevention and Treatment. Nutrients. 2021 Jul 9;13(7):2349. doi: 10.3390/nu13072349. PMID: 34371858; PMCID: PMC8308545.
19. Palmer K, Vetrano DL, Marengoni A, Tummolo AM, Villani ER, Acampora N, Bernabei R, Onder G. The Relationship between Anaemia and Frailty: A Systematic Review and Meta-Analysis of Observational Studies. J Nutr Health Aging. 2018;22(8):965-974. doi: 10.1007/s12603-018-1049-x. PMID: 30272101.
20. Piskovatska V, Storey KB, Vaiserman AM, Lushchak O. The Use of Metformin to Increase the Human Healthspan. Adv Exp Med Biol. 2020;1260:319-332. doi: 10.1007/978-3-030-42667-5_13. PMID: 32304040.
21. Puts MTE, Toubasi S, Andrew MK, Ashe MC, Ploeg J, Atkinson E, Ayala AP, Roy A, Rodríguez Monforte M, Bergman H, McGilton K. Interventions to prevent or reduce the level of frailty in community-dwelling older adults: a scoping review of the literature and international policies. Age Ageing. 2017 May 1;46(3):383-392. doi: 10.1093/ageing/afw247. PMID: 28064173; PMCID: PMC5405756.
22. Sanford AM. Anorexia of aging and its role for frailty. Curr Opin Clin Nutr Metab Care. 2017 Jan;20(1):54-60. doi: 10.1097/MCO.0000000000000336. PMID: 27749690.
23. Schoufour JD, Overdevest E, Weijs PJM, Tieland M. Dietary Protein, Exercise, and Frailty Domains. Nutrients. 2019 Oct 8;11(10):2399. doi: 10.3390/nu11102399. PMID: 31597289; PMCID: PMC6835617.
24. Sendama W. The effect of ageing on the resolution of inflammation. Ageing Res Rev. 2020 Jan;57:101000. doi: 10.1016/j.arr.2019.101000. Epub 2019 Dec 17. PMID: 31862417; PMCID: PMC6961112.
25. Shardell M, Semba RD, Kalyani RR, Bandinelli S, Prather AA, Chia CW, Ferrucci L. Plasma Klotho and Frailty in Older Adults: Findings From the InCHIANTI Study. J Gerontol A Biol Sci Med Sci. 2019 Jun 18;74(7):1052-1057. doi: 10.1093/gerona/glx202. PMID: 29053774; PMCID: PMC6580690.
26. Thillainadesan J, Scott IA, Le Couteur DG. Frailty, a multisystem ageing syndrome. Age Ageing. 2020 Aug 24;49(5):758-763. doi: 10.1093/ageing/afaa112. PMID: 32542377.
27. Triggle CR, Mohammed I, Bshesh K, Marei I, Ye K, Ding H, MacDonald R, Hollenberg MD, Hill MA. Metformin: Is it a drug for all reasons and diseases? Metabolism. 2022 Aug;133:155223. doi: 10.1016/j.metabol.2022.155223. Epub 2022 May 29. PMID: 35640743.
28. Vatic M, von Haehling S, Ebner N. Inflammatory biomarkers of frailty. Exp Gerontol. 2020 May;133:110858. doi: 10.1016/j.exger.2020.110858. Epub 2020 Jan 31. PMID: 32007546.
29. Verghese J, Ayers E, Sathyan S, Lipton RB, Milman S, Barzilai N, Wang C. Trajectories of frailty in aging: Prospective cohort study. PLoS One. 2021 Jul 12;16(7):e0253976. doi: 10.1371/journal.pone.0253976. PMID: 34252094; PMCID: PMC8274857.
30. Veronesi F, Borsari V, Cherubini A, Fini M. Association of Klotho with physical performance and frailty in middle-aged and older adults: A systematic review. Exp Gerontol. 2021 Oct 15;154:111518. doi: 10.1016/j.exger.2021.111518. Epub 2021 Aug 15. PMID: 34407459.
31. Xu Q, Ou X, Li J. The risk of falls among the aging population: A systematic review and meta-analysis. Front Public Health. 2022 Oct 17;10:902599. doi: 10.3389/fpubh.2022.902599. PMID: 36324472; PMCID: PMC9618649.
32. Zhou J, Wang J, Shen Y, Yang Y, Huang P, Chen S, Zou C, Dong B. The association between telomere length and frailty: A systematic review and meta-analysis. Exp Gerontol. 2018 Jun;106:16-20. doi: 10.1016/j.exger.2018.02.030. Epub