Department of Human Neuroscience, Sapienza University, Rome, Italy; National Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy; Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Division of Neurology, Department of Medicine, Dalhousie University, Halifax, NS, Canada; Nova Scotia Health, Halifax, NS, Canada.
Lancet Neurol. 2024 Nov;23(11):1147-1157. doi: 10.1016/S1474-4422(24)00291-6. Epub 2024 Sep 11.
The concept of frailty, now being adopted in most medical disciplines, is attracting growing interest in neurology. Every day, most neurologists care for patients with varying degrees of frailty, from very mild to very severe. Frailty exacerbates patients' health needs, complicates clinical decision making, and negatively affects their health outcomes. Increasing evidence suggests that frailty affects the risk, clinical presentation, and course of common age-related neurological disorders, including dementia, Parkinson's disease, stroke, and multiple sclerosis. Most neurologists should become familiar with assessing and measuring frailty. Doing so can provide information that is crucial for diagnosis, prognostication, and care planning. Consideration of frailty can help to elucidate the pathophysiological underpinnings of age-related neurological disorders, clarify the clinical validity and utility of candidate biomarkers, and identify novel therapeutic targets. Randomised controlled trials investigating late-life neurological diseases that address frailty have the potential to provide insight into these complex disorders.
衰弱的概念目前已在大多数医学学科中得到应用，在神经病学领域也引起了越来越多的关注。每天，大多数神经科医生都会治疗不同程度衰弱的患者，从非常轻微到非常严重。衰弱会加重患者的健康需求，使临床决策复杂化，并对其健康结果产生负面影响。越来越多的证据表明，衰弱会影响常见与年龄相关的神经退行性疾病的风险、临床表现和病程，包括痴呆、帕金森病、中风和多发性硬化症。大多数神经科医生应该熟悉评估和测量衰弱的方法。这样做可以提供对诊断、预后和护理计划至关重要的信息。考虑衰弱可以帮助阐明与年龄相关的神经退行性疾病的病理生理基础，阐明候选生物标志物的临床有效性和实用性，并确定新的治疗靶点。针对涉及衰弱的老年期神经疾病进行的随机对照试验有可能深入了解这些复杂的疾病。
