AGING AND FRAILTY

PRESSBOOK
● Sacropenia (loss of muscle mass and function) is a characteristic sign of frailty
● Net muscle mass is dependent on the breakdown and rebuilding rate of muscle (hypretrophy)
● Sacropenia comes from
○ Decreased quality control of mitochondria
○ Cell senescnece
○ Diet
○ Activity
○ Levels of oxygen
● Sacropenia is also a result of altered muscle stem cells, which diminish cell regenerative
properties
● the deficits (sarcopenia, decreased bone density and lack of social supports) on their own were
not enough to cause this very negative outcome (fall) due to the minor stressor event
(infection).
● accumulating deficits will make an individual more vulnerable to a minor stressor event.

● 5 stimulants for the phenotypic model of frailty

○ Weight loss
○ Exhaustion
○ Weakness (grip strength)
○ Slowness (walking speed)
○ Physical activity
● Cumulative deficit model of frailty
○ In this model, cognitive impairment or psychosocial factors are accounted for as part of
the frailty phenotype
○ A frailty index (FI) is calculated based on the accumulation of deficits
○ If there are 10 deficits adn a person has 5/10 of those deficits their FI = 0.5
○ This model allows for interventions to be made which are tailored to the individual
○ There are 92 identified deficits that could be counted based on the comprehensive
geriatric assessment (CGA)
○ Downside of this model: money and training needed to assess all 92 potential deficits
● Canadian longitudinal stud of aging (CLSA) at mcmaster (50,000 old people studied)