Skip to main content
SpringerLink
Log in

Zum Konzept der Gebrechlichkeit—

von der Phänomenologie zu therapeutischen Ansätzen

The concept of frailty—from phenomenology to therapeutic approaches

  • Published:
Zeitschrift für Gerontologie und Geriatrie Aims and scope Submit manuscript

Zusammenfassung

Frailty—als die Gebrechlichkeit vieler (hoch)-betagter Menschen—erzeugt viel menschliches Leid mit funktionellen Störungen sowie enorme gesundheitsökonomische Kosten. Die Sarkopenie (Muskelschwund) ist ebenfalls eine Form der Gebrechlichkeit und ist ein Mitverursacher zweier „geriatrischer Is“—der Immobilität und Instabilität. Pathophysiologisch kristallisiert sich immer mehr heraus, dass beiden Phänomenen entzündliche Ursachen zu Grunde liegen. Diese Entzündungsphänomene und die damit verbundenden gesundheitlichen Störungen lassen sich durch körperliche Aktivität und eine gesunde Ernährung partiell revertieren. In diesem Sinne zeichnen sich erfolgreiche therapeutische Ansätze ab, um diesen so häufigen und klinisch relevanten Phänomenen zu begegnen.

Summary

Frailty—the weakness of many (oldest) old persons—induces a lot of human sorrow with functional disabilities as well as health-economic costs. Sarcopenia (loss of muscle mass) is also a form of frailty and a co-factor of two of the “geriatric Is”—immobility and instability. Pathophysiologically, both phenomenons show signs of an inflammatory state. Physical activity and a healthy diet can partially reverse these health problems. Therefore, therapeutic strategies emerge to treat these frequent and clinically relevant phenomenons.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Ashcorft GS, Horan MA, Ferguson MW (1998) Aging alters the inflammatory and endothelial cell adhesion molecule profiles during human cuaneous wound healing. Lab Invest 78:47–58

    PubMed  Google Scholar 

  2. Bales CW, Ritchie CS (2002) Sarcopenia, weight loss, and nutritional frailty in the elderly. Annu Rev Nutr 22:309–323

    Article  PubMed  Google Scholar 

  3. Baumgartner RN, Waters DL, Gallagher D, Morley JE, Garry PJ (1999) Predictors of skeletal muscle mass in elderly men and women. Mech Ageing Dev 107:123–136

    Article  PubMed  Google Scholar 

  4. Doherty TJ (2003) Invited review: aging and sarcopenia. J Appl Physiol 95:1717–1727

    PubMed  Google Scholar 

  5. Ershler WB, Sun WH, Binkley N (1994) The role of interleukin-6 in certain age-related diseases. Drugs Aging 5:358–365

    PubMed  Google Scholar 

  6. Evans W (1997) Functional and metabolic consequences of sarcopenia. J Nutr 127(Suppl 5):998S–1003S

    PubMed  Google Scholar 

  7. Fried LP, Tangen CM, Walston J et al (2001) Cardiovascular Health Study Collaborative Research Group. J Gerontol A Biol Sci Med Sci 56:M146–M156

    PubMed  Google Scholar 

  8. Gill TM, Baker DI, Gottschalk M, Peduzzi PN, Allore H, Byers A (2002) A program to prevent functional decline in physically frail, elderly persons who live at home. N Engl J Med 347:1068–1074

    Article  PubMed  Google Scholar 

  9. Greenlund LJ, Nair KS (2003) Sarcopenia—consequences, mechanisms, and potential therapies. Mech Ageing Dev 124:287–299

    Article  PubMed  Google Scholar 

  10. Hamada K, Vannier E, Sacheck JM, Witsell AL, Roubenoff R (2005) Senescence of human skeletal muscle impairs the local inflammatory cytokine response to acute eccentric exercise. FASEB J 19:264–266

    PubMed  Google Scholar 

  11. Jones DM, Song X, Rockwood K (2004) Operationalizing a frailty index from a standardized comprehensive geriatric assessment. J Am Geriatr Soc 52:1929–1933

    Article  PubMed  Google Scholar 

  12. Leng SX, Cappola AR, Andersen RE, Blackman MR, Koenig K, Blair M,Walston JD (2004) Serum levels of insulinlike growth factor-I (IGF-I) and dehydroepiandrosterone sulfate (DHEA-S), and their relationships with serum interleukin-6, in the geriatric syndrome of frailty. Aging Clin Exp Res 16:153–157

    PubMed  Google Scholar 

  13. Martinussen T, Pipper CB (2005) Estimation in the positive stable shared frailty Cox proportional hazards model. Lifetime Data Anal 11:99–115

    Article  PubMed  MathSciNet  Google Scholar 

  14. Muhlberg W, Sieber C (2004) Sarcopenia and frailty in geriatric patients: implications for training and prevention. Z Gerontol Geriatr 37:2–8

    Article  PubMed  Google Scholar 

  15. Muhlberg W, Weidemann G, Stedtfeld HW, Sieber (2004) Low total protein increases injury risk in the elderly. J Am Geriatr Soc 52:324–325

    Article  PubMed  Google Scholar 

  16. Newman AB, Gottdiener JS, McBurnie MA, Hirsch CH, Kop WJ, Tracy R, Walston JD, Fried LP (2001) Associations of subclinical cardiovascular disease with frailty. J Gerontol A Biol Sci Med Sci 56:M158–M166

    PubMed  Google Scholar 

  17. Payette H, Roubenoff R, Jacques PF, Dinarello CA, Wilson PW, Abad LW, Harris T (2003) Insulin-like growth factor-1 and interleukin 6 predict sarcopenia in very old community-living men and women: the Framingham Heart Study. J Am Geriatr Soc 51:1237–1243

    Article  PubMed  Google Scholar 

  18. Rockwood K, Mogilner A, Mitnitski A (2004) Changes with age in the distribution of a frailty index. Mech Ageing Dev 125:517–519

    Article  PubMed  Google Scholar 

  19. Roubenoff R (2004) Sarcopenic obesity: the confluence of two epidemics. Obes Res 12:887–888

    PubMed  Google Scholar 

  20. Roubenoff R (2001) Origins and clinical relevance of sarcopenia. Can J Appl Physiol 26:78–89

    PubMed  Google Scholar 

  21. Roubenoff R (2000) Sarcopenia: a major modifiable cause of frailty in the elderly. J Nutr Health Aging 4:140–142

    PubMed  Google Scholar 

  22. Roubenoff R (1997) Inflammatory ad hormonal mediators of cachexia. J Nutr 127(Suppl 5):1014S–1016S

    PubMed  Google Scholar 

  23. Strawbridge WJ, Shema SJ, Balfour JL, Higby HR, Kaplan GA (1998) Antecedents of frailty over three decades in an older cohort. J Gerontol B Psychol Sci Soc Sci 53:S9–S16

    PubMed  Google Scholar 

  24. Vandervoort AA (2002) Aging of the human neuromuscular system. Muscle Nerve 25:17–25

    Article  PubMed  Google Scholar 

  25. Walston J, McBurnie MA, Newman A, Tracy RP, Kop WJ, Hirsch CH, Gottdiener J, Fried LP (2002) Frailty and activation of the inflammation and coagulation systems with and without clinical comorbidities: results form the Cardiovascular Health Study 162:2333–2341

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Lehrstuhl Innere Medizin V (Geriatrie) der Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Biomedizin des Alterns, Klinik II Klinikum Nürnberg, Prof.-Ernst-Nathan-Straße 1, 90419, Nürnberg, Germany

    C. C. Sieber

Authors
  1. C. C. Sieber
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. C. Sieber.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sieber, C.C. Zum Konzept der Gebrechlichkeit—. Z Gerontol Geriatr 38 (Suppl 1), i1–i3 (2005). https://doi.org/10.1007/s00391-005-1101-4

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00391-005-1101-4

Schlüsselwörter

Key words

Search

Navigation