Buchner D M, Wagner E H
Department of Health Services, University of Washington, Seattle.
Clin Geriatr Med. 1992 Feb;8(1):1-17.
Frailty is a state of reduced physiologic reserve associated with increased susceptibility to disability. Reduced physiologic capacity in neurologic control, mechanical performance, and energy metabolism are the major components of frailty. Although disease is an important cause of frailty, there is sufficient epidemiologic and experimental evidence to conclude that frailty is also due to the additive effects of low-grade physiologic loss resulting from a sedentary lifestyle and more rapid loss due to acute insults (illness, injuries, major life events) that result in periods of limited activity and bedrest. The pathogenesis of frailty involves a complicated interaction of factors that block recovery from rapid physiologic loss. To some extent, frailty is preventable. Approaches to prevention include (1) the periodic monitoring of key physiologic indicators of frailty, (2) the prevention of physiologic loss and acute and subacute episodes of physiologic loss, (3) the prediction of episodes of physiologic loss and the reduction of frailty prior to the loss, and (4) the removal of obstacles to recovery once physiologic loss has occurred.
衰弱是一种生理储备减少的状态，与残疾易感性增加相关。神经控制、机械性能和能量代谢方面的生理能力下降是衰弱的主要组成部分。虽然疾病是衰弱的一个重要原因，但有足够的流行病学和实验证据得出结论，衰弱也归因于久坐不动的生活方式导致的轻度生理功能丧失的累加效应，以及因急性损伤（疾病、伤害、重大生活事件）导致活动受限和卧床休息期而造成的更快的功能丧失。衰弱的发病机制涉及多种因素的复杂相互作用，这些因素阻碍了从快速生理功能丧失中恢复。在一定程度上，衰弱是可预防的。预防方法包括：（1）定期监测衰弱的关键生理指标；（2）预防生理功能丧失以及生理功能丧失的急性和亚急性发作；（3）预测生理功能丧失发作并在丧失之前减轻衰弱；（4）一旦发生生理功能丧失，消除恢复的障碍。
