West Virginia University, Morgantown, WV, USA.
Am Fam Physician. 2021 Feb 15;103(4):219-226.
Frailty, which is a geriatric syndrome that affects 5% to 17% of older adults, is a state of increased vulnerability across multiple health domains that leads to adverse health outcomes. Frail older adults are at increased risk of falls, disability, hospitalizations, and death. Frailty may initially be overlooked or incorrectly identified as part of the normal aging process because of the variable nature of the presentation and diagnosis. Symptoms include generalized weakness, exhaustion, slow gait, poor balance, decreased physical activity, cognitive impairment, and weight loss. There is no current recommendation for routine screening. A comprehensive geriatric assessment can identify risk factors and symptoms that suggest frailty. Several validated frailty assessment tools can evaluate a patient for frailty. Patients are diagnosed as not-frail, prefrail, or frail. Patients with a larger number of frail attributes are at higher risk of poor outcomes. The management of frail patients must be individualized and tailored to each patient's goals of care and life expectancy. Physical activity and balance exercises may be suitable for patients who are less frail. Palliative care and symptom control may be appropriate for those who are more frail.
衰弱是一种影响 5%至 17%老年人的老年综合征，是一种多个健康领域易受伤害的状态，会导致不良健康后果。虚弱的老年人跌倒、残疾、住院和死亡的风险增加。由于衰弱的表现和诊断具有多变性，衰弱可能最初被忽视或错误地认为是正常衰老过程的一部分。症状包括全身无力、疲惫、步态缓慢、平衡能力差、体力活动减少、认知障碍和体重减轻。目前没有常规筛查的建议。全面的老年评估可以识别出可能导致衰弱的风险因素和症状。有几种经过验证的衰弱评估工具可以评估患者是否患有衰弱。患者被诊断为不虚弱、虚弱前期或虚弱。具有更多虚弱特征的患者发生不良结局的风险更高。虚弱患者的管理必须个体化，并根据每位患者的护理目标和预期寿命进行调整。对于身体状况较差的患者，可能适合进行身体活动和平衡锻炼。对于身体状况更差的患者，姑息治疗和症状控制可能是合适的。
