Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.
Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Age Ageing. 2018 Jan 1;47(1):119-125. doi: 10.1093/ageing/afx122.
frailty is an increased vulnerability to adverse health outcomes, across multiple physiological systems, with both environmental and genetic drivers. The two most commonly used measures are Rockwood's frailty index (FI) and Fried's frailty phenotype (FP).
the present study included 3626 individuals from the TwinsUK Adult Twin Registry. We used the classical twin model to determine whether FI and FP share the same latent aetiological factors. We also investigated the relationship between frailty and chronic widespread musculoskeletal pain (CWP), another holistic age-related condition with significant clinical impact.
FP and FI shared underlying genetic and environmental aetiology. CWP was associated with both frailty measures, and health deficits appeared to mediate the relationship between phenotypic frailty and pain. Latent genetic factors underpinning CWP were shared with frailty. While frailty was increased in the twins reporting pain, co-twin regression analysis indicated that the relationship between CWP and frailty is reduced after accounting for shared genetic and environmental factors.
both measures of frailty tap the same root causes, thus this work helps unify frailty research. We confirmed a strong association between CWP and frailty, and showed a large and significant shared genetic aetiology of both phenomena. Our findings argue against pain being a significant causative factor in the development of frailty, favouring common causation. This study highlights the need to manage CWP in frail individuals and undertake a Comprehensive Geriatric Assessment in individuals presenting with CWP. Finally, the search for genetic factors underpinning CWP and frailty could be aided by integrating measures of pain and frailty.
虚弱是指在多个生理系统中，由于环境和遗传因素的共同作用，对不良健康结果的易感性增加。最常用的两种测量方法是罗克伍德的虚弱指数（FI）和弗里德的虚弱表型（FP）。
本研究纳入了来自英国双胞胎成人双胞胎登记处的 3626 名个体。我们使用经典的双胞胎模型来确定 FI 和 FP 是否具有相同的潜在病因因素。我们还研究了虚弱与慢性广泛肌肉骨骼疼痛（CWP）之间的关系，后者是另一种具有重大临床影响的整体性与年龄相关的疾病。
FP 和 FI 具有共同的潜在遗传和环境病因。CWP 与两种虚弱测量方法相关，健康缺陷似乎介导了表型虚弱与疼痛之间的关系。CWP 背后的潜在遗传因素与虚弱有关。虽然报告疼痛的双胞胎中虚弱程度增加，但双胞胎回归分析表明，在考虑共同遗传和环境因素后，CWP 与虚弱之间的关系减弱。
两种虚弱测量方法都涉及相同的根本原因，因此这项工作有助于统一虚弱研究。我们证实了 CWP 与虚弱之间存在很强的关联，并显示了这两种现象具有很大且显著的共同遗传病因。我们的研究结果表明，疼痛不是导致虚弱的重要原因，而是共同原因。本研究强调了在虚弱个体中管理 CWP 和在出现 CWP 的个体中进行全面老年评估的必要性。最后，通过整合疼痛和虚弱的测量方法，可能有助于寻找 CWP 和虚弱的遗传基础。
