Balducci Lodovico
Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL 33612, USA.
Interdiscip Top Gerontol. 2013;38:61-72. doi: 10.1159/000343586. Epub 2013 Jan 17.
The construct of frailty is germane to that of aging, but a clinical definition of frailty is still wanted. In the geriatric literature, frailty has been conceived in two different ways. The first one is a threshold beyond which the functional reserve of a person is critically reduced and the tolerance of stress negligible. The second is as a progressive reduction of functional reserve due to a progressive accumulation of deficit. In this construct it may be hard to distinguish frailty from aging. Neither concept has at present a clear application in the management of older cancer patients. Studies are needed to establish whether the construct of frailty proposed by Fried et al. may be predictive of decreased cancer-independent survival and of decreased treatment tolerance in older cancer patients.
衰弱的概念与衰老相关,但仍需要一个衰弱的临床定义。在老年医学文献中,衰弱有两种不同的概念。第一种是一个阈值,超过这个阈值,人的功能储备会严重降低,对压力的耐受性可忽略不计。第二种是由于缺陷的逐渐积累导致功能储备的逐渐减少。在这个概念中,可能很难将衰弱与衰老区分开来。目前这两个概念在老年癌症患者的管理中都没有明确的应用。需要开展研究来确定弗里德等人提出的衰弱概念是否可以预测老年癌症患者非癌症相关生存率的降低以及治疗耐受性的降低。