Frailty after COVID‐19: The wave after?

The COVID‐19 pandemic poses an ongoing public health challenge, with a focus on older adults. Given the large number of older persons who have recovered from COVID‐19 and reports of long‐lasting sequelae, there is reasonable concern that the COVID‐19 pandemic may lead to a long‐term deterioration in the health of older adults, i.e., a potential “wave of frailty.” Therefore, it is critical to better understand the circumstances surrounding the development of frailty as a result of COVID‐19, as well as the underlying mechanisms and factors contributing to this development. We conducted a narrative review of the most relevant articles published on the association between COVID‐19 and frailty through January 2023. Although few studies to date have addressed the effects of COVID‐19 on the onset and progression of frailty, the available data suggest that there is indeed an increase in frailty in the elderly as a result of COVID‐19. Regarding the underlying mechanisms, a multicausal genesis can be assumed, involving both direct viral effects and indirect effects, particularly from the imposed lockdowns with devastating consequences for the elderly: decreased physical activity, altered diet, sarcopenia, fatigue, social isolation, neurological problems, inflammation, and cardiovascular morbidity are among the possible mediators. Since the COVID‐19 pandemic is leading to an increase in frailty in the elderly, there is an urgent need to raise awareness of this still little‐known problem of potentially great public health importance and to find appropriate prevention and treatment measures.