Division of Geriatric Medicine, Dalhousie University, Halifax, Room 1421, 5955 Veterans' Memorial Lane, Nova Scotia B3H 2E1, Canada.
Clin Geriatr Med. 2011 Feb;27(1):17-26. doi: 10.1016/j.cger.2010.08.008.
As nonreplicative cells age, they commonly accumulate subcellular deficits that can compromise function. As people age, they too experience problems that can accumulate. As deficits (symptoms, signs, illnesses, disabilities) accumulate, people become more susceptible to adverse health outcomes, including worse health and even death. This state of increased risk of adverse health outcomes is indistinguishable from the idea of frailty, so deficit accumulation represents another way to define frailty. Counting deficits not only allows grades of frailty to be discerned but also provides insights into the complex problems of older adults. This process is potentially useful to geriatricians who need to be experts in managing complexity. A key to managing complexity is through instruments such as a comprehensive geriatric assessment, which can serve as the basis for routine clinical estimation of an individual's degree of frailty. Understanding people and their needs as deficits accumulate is an exciting challenge for clinical research on frailty and its management by geriatricians.
随着非复制细胞的衰老,它们通常会积累亚细胞缺陷,从而影响其功能。随着人们年龄的增长,他们也会遇到各种问题,这些问题会逐渐积累。随着缺陷(症状、体征、疾病、残疾)的积累,人们更容易出现不良健康后果,包括健康状况恶化甚至死亡。这种不良健康后果风险增加的状态与虚弱的概念难以区分,因此,缺陷积累代表了定义虚弱的另一种方式。计算缺陷不仅可以区分虚弱的程度,还可以深入了解老年人的复杂问题。这一过程对于需要精通复杂性管理的老年病学家来说具有潜在的应用价值。管理复杂性的关键是通过综合老年评估等工具,为常规临床评估个体虚弱程度提供依据。随着缺陷的积累,了解人和他们的需求是对老年病学家进行虚弱及其管理的临床研究的一个令人兴奋的挑战。