Valvani Rachna, Javed Nismat, Vittorio Timothy, Mohyeldin Moiud
Internist Geriatrician, Associate Program Director Internal Medicine Residency Program, North Alabama Medical Center, Florence, AL, USA.
Resident Physician, Department of Internal Medicine, BronxCare Health System, Bronx, NY, USA.
J Community Hosp Intern Med Perspect. 2024 Jul 2;14(4):25-33. doi: 10.55729/2000-9666.1344. eCollection 2024.
The aging demographic landscape of the United States highlights a concomitant rise in chronic conditions and infectious diseases. Older adults face a heightened susceptibility to infections, particularly pneumonia and urinary tract infections, and comorbidities such as cancer, cardiovascular disease, and dementia. Frailty, defined by a set of phenotypic criteria, emerges as a crucial predictor of adverse outcomes in infections, affecting hospitalization and post-care interventions. In the context of cancer, various frailty indices demonstrate their utility in predicting complications, mortality, and long-term outcomes. Cardiovascular diseases, including acute coronary syndrome and myocardial infarctions, exhibit varied associations with frailty, influencing both short-term and long-term prognosis. Frailty's impact extends to valvular heart disease, necessitating risk assessment and tailored care. In dementia patients, frailty is linked to cognitive decline, mortality, depression, and reduced daily living activities, emphasizing the need for holistic assessment and intervention. This review explores the role of frailty indices in predicting outcomes across diverse health conditions, with a focus on infections, cancer, cardiovascular disease, and dementia. Future interventions should address the role of frailty in predicting poor prognostic outcomes, including mortality, readmission rates, and complications across diverse health conditions.
美国人口老龄化的格局凸显了慢性病和传染病的同步增加。老年人更容易受到感染,尤其是肺炎和尿路感染,以及癌症、心血管疾病和痴呆症等合并症的影响。由一组表型标准定义的虚弱,成为感染不良后果的关键预测因素,影响住院治疗和出院后干预措施。在癌症方面,各种虚弱指数显示出它们在预测并发症、死亡率和长期结果方面的效用。心血管疾病,包括急性冠状动脉综合征和心肌梗死,与虚弱表现出不同的关联,影响短期和长期预后。虚弱的影响延伸到心脏瓣膜病,需要进行风险评估和个性化护理。在痴呆症患者中,虚弱与认知能力下降、死亡率、抑郁症和日常生活活动减少有关,强调了全面评估和干预的必要性。本综述探讨了虚弱指数在预测各种健康状况结局中的作用,重点关注感染、癌症、心血管疾病和痴呆症。未来的干预措施应解决虚弱在预测不良预后结局中的作用,包括不同健康状况下的死亡率、再入院率和并发症。
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