frailty in elderly
review of frailty in elderly in the recent lancet (see geriatrics frailty lancet 2013 in dropbox). a bit hard to define frailty , but mostly has to do with increased vulnerability, with disproportionately large changes from small insults (eg new drugs, minor infections). seems to be an accumulation of molecular and cellular damage from many mechanisms over time. one recent study found that in assessing 12 measures of dysfunction in 6 different systems , abnormal results in 3 or more systems was more predictive of frailty, and, specifically, the number of abnormal systems was more predictive than abnormalities in any particular system (i have seen several older people with small, potentially reversible problems in several different organ systems -- a little heart failure, renal dysfunction, infection -- and i anticipated being able to fix each one, but with the multi-system issues in aggregate the patients have done poorly). so, a few...