Integrative approach to elderly frailty

Elderly frailty has been recognized as a distinct clinical syndrome with a physiologic basis. It reflects a decreased functional reserve and consequent reduction in resilience to any stressors. It is important to understand that frailty process could be a transitional state with dynamic properties: normal aging→pre-frail→frailty→complication status. Hence, frailty could be preventable and its progression may be delayed. Furthermore, there is the potential reversibility of many of its features. The earlier stages of frailty might not be clinically apparent, but later stages manifest as significant deficits accumulate. The major phenotype of frailty includes weight loss, sarcopenia, relative inactivity, decreased balance and mobility, decreased cognitive function, and impaired nutritional status. Therefore, frail patients could be implicated by decreased performance status and have a significantly increased risk of cardiovascular diseases, cancer, falls and mortality. Regular exercise, essential amino acid and vitamin D are recommendable to prevent and treat elderly frailty, but hormone replacement therapy does not have consistent evidence yet. In upcoming (super) aging society, the importance of elderly frailty would be more noticed and multidisplinary approach should be actively performed.