Frailty

A state of increased vulnerability to stressors, following declines in function and reserves across multiple physiologic systems, characterized by MUSCLE WEAKNESS; FATIGUE; slowed motor performance; low physical activity; and unintentional weight loss.

Also Known As:

Networked: 8461 relevant articles (292 outcomes, 1501 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Sarcopenia
2.	Cognitive Dysfunction
3.	Neoplasms (Cancer)
4.	Heart Failure
5.	Dementia (Dementias)

Experts

1.	Rockwood, Kenneth: 68 articles (03/2022 - 02/2002)
2.	Cesari, Matteo: 59 articles (08/2022 - 05/2006)
3.	Walston, Jeremy D: 45 articles (10/2022 - 04/2004)
4.	Segev, Dorry L: 44 articles (02/2022 - 06/2010)
5.	Fried, Linda P: 42 articles (01/2021 - 11/2002)
6.	Ferrucci, Luigi: 40 articles (05/2022 - 06/2005)
7.	Gobbens, Robbert J J: 39 articles (07/2022 - 06/2010)
8.	Xue, Qian-Li: 36 articles (05/2022 - 05/2005)
9.	Vellas, Bruno: 31 articles (11/2022 - 06/2013)
10.	Vellas, B: 31 articles (01/2022 - 07/2000)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Frailty:

1.	Proteins (Proteins, Gene)FDA Link 10/01/2015 - "Among those interventions, physical activity with or without protein supplementation has demonstrated to be effective in improving muscle mass and function and in preventing disability and frailty in older persons. " 04/01/2015 - "We prepared a bonito fish (BF) and defatted BF (DBF) and hypothesized that protein contained in BF and DBF would be effective for mitigating the effects of T2DM-induced bone frailty. " 01/01/2023 - "Protein-rich food items, such as meat; eggs; and beans, were associated with protective effects against frailty. " 01/01/2014 - "1) To investigate factors associated with stronger benefits from protein-energy supplementation, and 2) to test the hypothesis that the severity of frailty is associated with the efficacy of protein-energy supplementation. " 01/01/2020 - "This study identified novel proteins and pathways related to frailty that may offer improved frailty phenotyping and prediction."
2.	Biomarkers (Surrogate Marker)IBA 01/01/2016 - "This program is unique in that it leads to a decrease in the number of visits to primary care physician (trained group 1.3 SD 1.4 vs 2.4 SD 2.9 control group) and to a significant improvement in frailty biomarkers. " 07/01/2023 - "We applied a 4-step established approach (identify frailty domain variable bivariate associations with the outcome of waitlist delisting or death; build models sequentially incorporating variables from each frailty domain cluster; retain variables that improved model performance ability by c-statistic or AIC) to develop 3 candidate "Lung Transplant Frailty Scale (LT-FS)" measures: 1 incorporating readily available clinical data; 1 adding muscle mass, and 1 adding muscle mass and research-grade Biomarkers. " 01/01/2021 - "Distinct sets of commonly available biomarkers were associated with development of frailty and monitoring these biomarkers in patients may allow for earlier detection and possible prevention of frailty, with the potential for improved quality of life." 01/01/2018 - "Although further validation and research studies are warranted, our study identified eight novel candidate biomarkers of frailty that may help to elucidate the multifactorial pathogenesis of frailty." 01/01/2018 - "The accuracy of risk estimation will be further increased by improved assessment of physical fitness, frailty, and incorporation of existing and novel biomarkers. "
3.	Indicators and Reagents (Reagents)IBA 10/01/2002 - "Poor muscle strength may be a good indicator of overall vulnerability and frailty in old age, and strength testing could be helpful in targeting older people for preventive interventions." 07/01/2000 - "Significant improvement was made by the exercise group on our primary indicator of frailty, a physical performance test (PPT) (29 +/- 4 vs 31 +/- 4 out of a possible 36 points), as well as many of the risk factors previously identified as contributors to frailty; eg, reductions in flexibility, strength, gait speed, and poor balance. " 04/30/2006 - "A quantifiable indicator of frailty would be very useful in assessing the health state of older populations, as well as enable the effect of interventions to be evaluated over time. " 01/01/2022 - "Adding mobility status as a frailty indicator to TTAS only slightly improved its ability to predict in-hospital mortality (AUROC: 0.74-0.77) in patients ≥65 years of age. " 01/01/2018 - "Using the Frailty Index (FI) as "gold standard," we compared (1) the diagnostic performance of 3 frailty measures (FRAIL, Clinical Frailty Scale [CFS], and Tilburg Frailty Indicator [TFI]) in identifying frailty, and (2) their ability to predict negative outcomes at 12 months after enrollment. "
4.	ninjin'yoeitoIBA 01/01/2019 - "As the checklist contains many aspects of frailty, Ninjin'yoeito might be beneficial in preventing frailty. " 01/01/2021 - "Conclusion: Patients with frailty often have a worsened SF-36 score after discharge following acute illness, but the score may be improved by taking ninjin'yoeito." 06/01/2023 - "In this study, we investigated the potential of Ninjin'yoeito (NYT), a traditional Chinese herbal medicine, as a viable treatment option for frailty. " 01/01/2023 - "This study aimed to investigate the effect of the multicomponent drug, ninjin'yoeito (NYT), on frailty in MCI and mild AD patients. " 01/01/2018 - "This review includes recent anti-aging studies and describes the effects and mechanisms of Ninjin'yoeito (Ren Shen Yang Ying Tang) when used for frailty or to extend a healthy life expectancy."
5.	VaccinesIBA 01/01/2021 - "However, the paucity of studies, the absence of tools to predict vaccine efficacy, and the lack of studies investigating the efficacy of newer vaccines in presence of frailty, strongly limit the formulation of more personalized immunization strategies for older adults. " 01/01/2019 - "Accounting for the number of exposures in the vaccine and placebo arms eliminated this bias completely, and the more realistic option of including a frailty term to model exposure as a random effect reduced this bias partially. " 01/01/2023 - "Additionally, no studies to date have explored potential variation in comparative vaccine safety across subgroups with frailty or an increased risk of adverse events, information that would be useful for tailoring clinical decisions. " 01/01/2022 - "For both vaccines, a major gap in the literature is apparent, whereby very few studies investigate sex-specific effects of aging, frailty, or multimorbidity. " 01/01/2022 - "Frailty should be considered in vaccine studies and prevention strategies."
6.	dapagliflozinIBA 10/18/2022 - "The improvement in health-related quality of life with dapagliflozin occurred early and was greater in patients with a higher level of frailty. " 08/01/2023 - "Here we examined the safety and efficacy of dapagliflozin in patients with CKD by frailty level. " 01/01/2022 - "Dapagliflozin improved all outcomes examined, regardless of frailty status. " 01/01/2023 - "In this prespecified analysis of the DELIVER trial, the proportional rates approach of Lin, Wei, Yang, and Ying (LWYY) and a joint frailty model were used to examine the effect of dapagliflozin on total HF events and cardiovascular death. " 08/01/2023 - "The relative benefit of dapagliflozin for all outcomes was consistent across all frailty categories, with no difference in associated safety."
7.	Testosterone (Sustanon)FDA Link 01/01/2022 - "This study investigated how serum testosterone related to frailty in ageing male C57Bl/6 mice with or without lifelong testosterone deficiency. " 01/01/2019 - "Testosterone replacement may be a feasible therapeutic target toward prevention of frailty, although clinical trials are needed to test this possibility." 01/01/2018 - "Age-related decline in serum testosterone (T) has been suggested in some studies to be associated with individual components of frailty: diminished energy, muscle strength and physical function. " 12/01/2012 - "In this US nationally representative study of older men, low free testosterone and high SHBG serum levels were associated with a significantly increased odds of frailty after adjustment for age and race/ethnicity. " 06/01/2012 - "Frailty development was related only in men with testosterone levels at the beginning of the study (p = 0.017). "
8.	Glucose (Dextrose)FDA LinkGeneric 03/01/2022 - "Interestingly, retrospective observational studies confirmed these reassuring findings in real-life conditions in more heterogeneous and possibly more frailty populations also commonly treated with RAAS blockers by showing a reduced risk of AKI with SGLT2is compared with other glucose-lowering drugs. " 07/01/2023 - "Preoperative glucose in surgical oncology patient is not associated with postoperative outcomes after adjustment for frailty." 04/01/2023 - "Older adults with diabetes in the hospital are generally managed similarly to younger adults, however, it is unknown if the degree of frailty can affect glucose control among hospitalized patients. " 01/01/2022 - "Overall, most interventions resulted in improvements in certain parameters when compared to control (glucose homeostasis, cognitive function, frailty phenotype, gut microbiota profile, immune parameters), while others remained unvariable. " 01/01/2022 - "These changes indicate that glucose metabolism may be one mechanism by which GM inactivation causes frailty. "
9.	Insulin (Novolin)FDA Link 12/08/2021 - "EXercise to Prevent frailty and Loss Of independence in insulin treated older people with DiabetEs (EXPLODE): protocol for a feasibility randomised controlled trial (RCT)." 12/01/2019 - "This study was conducted to access the association between HOMA-IR and frailty in the United States of America (U.S.) middle-aged and elderly high-risk insulin-resistant population. " 08/28/2023 - "Frailty risk was greater in the insulin-resistant compared to the other subgroups (both aOR=2.0, both p<.001). " 10/01/2021 - "In this nationwide Medicare cohort, initiating an SGLT-2i was not associated with an increased risk of fracture in older adults with T2D compared with initiating a DPP-4i or GLP-1RA, with consistent results across categories of frailty, age, and insulin use. " 10/01/2021 - "Results were consistent across categories of sex, frailty (nonfrail, prefrail, and frail), age (<75 and ≥75 years), and insulin use (baseline users and nonusers). "
10.	Vitamin DFDA LinkGeneric 01/01/2020 - "Future studies should examine whether the favorable effect of low vitamin D levels on the course of frailty can be explained by confounding or whether unknown pathophysiological mechanisms may exert protective effects." 01/01/2018 - "Further studies should address the underlying mechanisms to explain this relationship and to determine whether vitamin D supplementation is effective for preventing frailty syndrome." 06/16/2023 - "These studies found no benefit of 2 000 IU/d of supplemental vitamin D on nonvertebral fractures, falls, functional decline, or frailty. " 01/01/2023 - "Using the Study to Understand Fall Reduction and Vitamin D in You data from 477 robust/prefrail adults (mean age = 76 ± 5 yr; 42% women), we examined whether accelerometer patterns (activity counts per day, active minutes per day, and activity fragmentation [broken accumulation]) were associated with incident frailty using Cox proportional hazard regression. " 10/01/2022 - "This secondary analysis aimed to examine the effects of vitamin D supplementation on frailty using data from the Study To Understand Fall Reduction and Vitamin D in You (STURDY). "

Therapies and Procedures

1.	Therapeutics 01/01/2022 - "Nearly 85% of patients who were frail prior to treatment demonstrated improvement in frailty following treatment CONCLUSIONS: Response to anti-TNF therapy is an important determinant of post-treatment frailty in patients with IBD. " 07/26/2023 - "Baseline frailty modified the efficacy of ICD therapy with a significant mortality benefit observed among participants with HFrEF and a low frailty burden but not among those with a high frailty burden." 12/01/2019 - "More preclinical experiments and clinical trials are warranted to precisely elucidate the mechanism, safety, and efficacy of frailty stem cell therapy." 11/30/2017 - "CONCLUSIONS    Bortezomib‑based regimens are effective and well tolerated in the first‑line therapy of elderly patients with MM and comorbidities, with advanced disease, and light chain MM. A more detailed assessment of patients' frailty is needed to increase the efficacy of treatment." 03/27/2022 - "In conclusion, older AHF patients with frailty showed greater improvement in lower extremity function with the addition of EMS therapy to early rehabilitation without adverse events."
2.	Activities of Daily Living (ADL) 02/01/2018 - "When evaluating frailty measures post BAV, we saw no significant improvement in mean GS, however, we observed a significant improvement in non-ambulatory patients and ADL scores. " 01/01/2017 - "Our aim was to study whether the acute care of such patients in a comprehensive geriatric assessment (CGA) unit is superior to care in a conventional acute medical care unit when it comes to activities of daily living (ADLs), frailty, and use of municipal help services. " 03/01/2012 - "To examine the outcomes of the Elderly Persons in the Risk Zone study, which was designed to evaluate whether it is possible to delay deterioration if a health-promoting intervention is made when an older adult (≥80) is at risk of becoming frail and whether a multiprofessional group intervention is more effective in delaying deterioration than a single preventive home visit with regard to frailty, self-rated health, and activities of daily living (ADLs) at 3-month follow-up. " 11/01/2023 - "Improved activities of daily living, physical function, outdoor activities, and cognitive function were major causes of improved frailty in 2019." 11/01/2013 - "However, available data do not suggest improvement in frailty upon initiation of dialysis; rather, the trajectory appears to be toward higher levels of dependence in activities of daily living (ADLs) after dialysis initiation. "
3.	Polypharmacy 06/01/2018 - "Furthermore, baseline cerebral vascular accident diagnosis (P = .022), high polypharmacy (P = .037), a higher Geriatric Depression Scale score (P = .033), and a lower Mini Nutritional Assessment score (P = .039) were significantly associated with improved frailty at the 2-year follow-up. " 01/01/2023 - "Additionally, frail older adults with polypharmacy were less likely to experience an improvement in frailty states, had higher risks of mortality, were more likely to suffer adverse hospital-related outcomes, and required additional assistance compared to those without polypharmacy. " 01/01/2023 - "Geriatric syndromes, including frailty, multimorbidity, impaired cognitive and physical function, polypharmacy, and other complexities of care, can undermine the therapeutic efficacy of guidelines-based treatments and the resiliency of older adults to survive and recover, as well. " 01/01/2023 - "Of note, SGLT-2i should be considered earlier in the diabetes treatment in both groups due to their multiple benefits, i.e., organ protective effects, the potential to reduce polypharmacy, and improve frailty status. " 02/14/2020 - "After adding pre-specified frailty characteristics (polypharmacy, gait speed, physical disability, preoperative health-related quality of life, and living alone) to this model, the c-statistic improved to 0.78 (95% CI: 0.73-0.83). "
4.	Drug Therapy (Chemotherapy) 07/01/2022 - "Although intensive chemotherapy was historically considered the only effective treatment for these patients, many older patients are not suitable for intensive chemotherapy owing to comorbidities or general frailty. " 07/01/2008 - "Due to advanced stage of the disease and general debility of the patient, although dubulking and chemotherapy course was not perfect but patient improved in her general condition. " 01/01/2006 - "Whereas short-term toxicity of chemotherapy can usually be considered acceptable even for a small improvement in survival, long-term toxicity such as early onset frailty can have an impact on quality of life that could last for years. " 12/01/2022 - "The purpose of this study is to assess the relationship between chemotherapy toxicity and frailty as determined using the Edmonton Frail Scale (EFS). " 11/01/2022 - "The objective of this study was to evaluate frailty prior to receipt of moderately- or highly-emetogenic chemotherapy and acute changes in QOL in patients at least 65 years of age. "
5.	Preoperative Exercise 07/01/2022 - "Prehabilitation, frailty assessment, and risk stratification are beneficial in complex cases. " 05/01/2021 - "Frailty, as assessed by Fried frailty criteria, improved significantly after prehabilitation (P < .0001). " 01/01/2022 - "The objective of this trial is to evaluate the efficacy of home-based multimodal prehabilitation in decreasing patient-reported disability and postoperative complications in older people with frailty having major surgery. " 09/11/2023 - "A prespecified multivariable model may help to explain a modest degree of variation in prehabilitation adherence in older people with frailty. " 08/01/2023 - "Establishing a gold standard for measuring frailty will improve identification of vulnerable, older patients, and subsequently direct designs for population-specific, multimodal prehabilitation to reduce postoperative morbidity and mortality."