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如何纳入社会因素以确定衰弱状态?

How to Include the Social Factor for Determining Frailty?

作者信息

Gutiérrez-Robledo L M, Avila-Funes J A

机构信息

Luis Miguel Gutiérrez-Robledo. Director General. Instituto de Geriatría at the National Institutes of Health Mexico. Periférico Sur 2767 Col. San Jerónimo Lídice. CP 10200; Magdalena Contreras, Distrito Federal, México. E-mail:

出版信息

J Frailty Aging. 2012;1(1):13-7. doi: 10.14283/jfa.2012.3.

Abstract

Traditionally, frailty has been understood as a biological syndrome associated with bad health-related outcomes. However, nowadays there are no universally accepted diagnostic criteria for this syndrome, much less studies approaching it from a non-biological framework. Some previous work has been able to highlight social factors as important features implicated in the development of this entity, and are now recognized as relevant to understand frailty. However, research in this field is still limited. It seems clear that social factors, often ignored in the medical context, might represent risk factors for the development of this geriatric syndrome. To identify these factors, as well as their role in the physiopathology of frailty, could be of great importance in order to establish potential multidimensional models to treat frailty. A life course approach to determine the correlates and trajectories of frailty seems to be necessary. The allostatic load through life and chronic inflammation in the elderly are potential mediators of this relationship. Therefore, social profile should be systematically assessed and taken into account when evaluating an elderly person. So, the present review proposes how to include social factors as another determinant of frailty.

摘要

传统上,衰弱被理解为一种与不良健康相关结局相关的生物学综合征。然而,如今对于这种综合征尚无普遍接受的诊断标准,更没有从非生物学框架对其进行研究。先前的一些工作已能够强调社会因素是该实体发展中涉及的重要特征,并且现在被认为与理解衰弱相关。然而,该领域的研究仍然有限。很明显,在医学背景中常常被忽视的社会因素可能是这种老年综合征发展的风险因素。识别这些因素及其在衰弱病理生理学中的作用,对于建立潜在的多维模型来治疗衰弱可能非常重要。采用生命历程方法来确定衰弱的相关因素和轨迹似乎很有必要。一生中的应激负荷和老年人的慢性炎症是这种关系的潜在调节因素。因此,在评估老年人时,应系统地评估并考虑其社会状况。所以,本综述提出了如何将社会因素纳入衰弱的另一个决定因素。

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