Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1070, New York, NY 10029, USA.
Clin Geriatr Med. 2011 Feb;27(1):89-100. doi: 10.1016/j.cger.2010.08.007.
Frailty and its management represent an emerging area of clinical care in older adults. Geriatricians have long recognized a syndrome of multiple comorbid conditions, immobility, weakness, and poor tolerance of physiologic stressors in older adults. Patients with these characteristics are described as frail and suffer increased adverse clinical outcomes. This article reviews the clinical spectrum of frailty in older adults, its biologic etiology, and potential clinical interventions. Several operational definitions of frailty and the associated clinical signs, symptoms, and outcomes are outlined. The biologic mechanisms hypothesized to underlie frailty are explored, particularly in the musculoskeletal, endocrine, and immune systems. Treatment options for frail, older adults are discussed, including physiologic system-targeted interventions and geriatric models of care.
虚弱及其管理是老年人临床护理中一个新兴的领域。老年病医生早就认识到老年人存在多种合并症、活动能力丧失、虚弱以及对生理应激源的耐受性差的综合征。具有这些特征的患者被描述为虚弱，并遭受更多的不良临床结局。本文综述了老年人虚弱的临床谱、其生物学病因以及潜在的临床干预措施。概述了几种虚弱的操作性定义以及相关的临床体征、症状和结果。探讨了假设导致虚弱的生物学机制，特别是在肌肉骨骼、内分泌和免疫系统中。讨论了针对虚弱的老年患者的治疗选择，包括针对生理系统的干预措施和老年护理模式。
