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Multisystem physiological perspective of human frailty and its modulation by physical activity

“Frailty” is a term used to refer to a state characterized by enhanced vulnerability to, and impaired recovery from, stressors compared with a nonfrail state, which is increasingly viewed as a loss of resilience. With increasing life expectancy and the associated rise in years spent with physical fr...

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Autores principales: Taylor, Joseph A., Greenhaff, Paul L., Bartlett, David B., Jackson, Thomas A., Duggal, Niharika A., Lord, Janet M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Physiological Society 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9886361/
https://www.ncbi.nlm.nih.gov/pubmed/36239451
http://dx.doi.org/10.1152/physrev.00037.2021
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author Taylor, Joseph A.
Greenhaff, Paul L.
Bartlett, David B.
Jackson, Thomas A.
Duggal, Niharika A.
Lord, Janet M.
author_facet Taylor, Joseph A.
Greenhaff, Paul L.
Bartlett, David B.
Jackson, Thomas A.
Duggal, Niharika A.
Lord, Janet M.
author_sort Taylor, Joseph A.
collection PubMed
description “Frailty” is a term used to refer to a state characterized by enhanced vulnerability to, and impaired recovery from, stressors compared with a nonfrail state, which is increasingly viewed as a loss of resilience. With increasing life expectancy and the associated rise in years spent with physical frailty, there is a need to understand the clinical and physiological features of frailty and the factors driving it. We describe the clinical definitions of age-related frailty and their limitations in allowing us to understand the pathogenesis of this prevalent condition. Given that age-related frailty manifests in the form of functional declines such as poor balance, falls, and immobility, as an alternative we view frailty from a physiological viewpoint and describe what is known of the organ-based components of frailty, including adiposity, the brain, and neuromuscular, skeletal muscle, immune, and cardiovascular systems, as individual systems and as components in multisystem dysregulation. By doing so we aim to highlight current understanding of the physiological phenotype of frailty and reveal key knowledge gaps and potential mechanistic drivers of the trajectory to frailty. We also review the studies in humans that have intervened with exercise to reduce frailty. We conclude that more longitudinal and interventional clinical studies are required in older adults. Such observational studies should interrogate the progression from a nonfrail to a frail state, assessing individual elements of frailty to produce a deep physiological phenotype of the syndrome. The findings will identify mechanistic drivers of frailty and allow targeted interventions to diminish frailty progression.
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spelling pubmed-98863612023-02-08 Multisystem physiological perspective of human frailty and its modulation by physical activity Taylor, Joseph A. Greenhaff, Paul L. Bartlett, David B. Jackson, Thomas A. Duggal, Niharika A. Lord, Janet M. Physiol Rev Review “Frailty” is a term used to refer to a state characterized by enhanced vulnerability to, and impaired recovery from, stressors compared with a nonfrail state, which is increasingly viewed as a loss of resilience. With increasing life expectancy and the associated rise in years spent with physical frailty, there is a need to understand the clinical and physiological features of frailty and the factors driving it. We describe the clinical definitions of age-related frailty and their limitations in allowing us to understand the pathogenesis of this prevalent condition. Given that age-related frailty manifests in the form of functional declines such as poor balance, falls, and immobility, as an alternative we view frailty from a physiological viewpoint and describe what is known of the organ-based components of frailty, including adiposity, the brain, and neuromuscular, skeletal muscle, immune, and cardiovascular systems, as individual systems and as components in multisystem dysregulation. By doing so we aim to highlight current understanding of the physiological phenotype of frailty and reveal key knowledge gaps and potential mechanistic drivers of the trajectory to frailty. We also review the studies in humans that have intervened with exercise to reduce frailty. We conclude that more longitudinal and interventional clinical studies are required in older adults. Such observational studies should interrogate the progression from a nonfrail to a frail state, assessing individual elements of frailty to produce a deep physiological phenotype of the syndrome. The findings will identify mechanistic drivers of frailty and allow targeted interventions to diminish frailty progression. American Physiological Society 2023-04-01 2022-10-14 /pmc/articles/PMC9886361/ /pubmed/36239451 http://dx.doi.org/10.1152/physrev.00037.2021 Text en Copyright © 2023 The Authors https://creativecommons.org/licenses/by/4.0/Licensed under Creative Commons Attribution CC-BY 4.0 (https://creativecommons.org/licenses/by/4.0/) . Published by the American Physiological Society.
spellingShingle Review
Taylor, Joseph A.
Greenhaff, Paul L.
Bartlett, David B.
Jackson, Thomas A.
Duggal, Niharika A.
Lord, Janet M.
Multisystem physiological perspective of human frailty and its modulation by physical activity
title Multisystem physiological perspective of human frailty and its modulation by physical activity
title_full Multisystem physiological perspective of human frailty and its modulation by physical activity
title_fullStr Multisystem physiological perspective of human frailty and its modulation by physical activity
title_full_unstemmed Multisystem physiological perspective of human frailty and its modulation by physical activity
title_short Multisystem physiological perspective of human frailty and its modulation by physical activity
title_sort multisystem physiological perspective of human frailty and its modulation by physical activity
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9886361/
https://www.ncbi.nlm.nih.gov/pubmed/36239451
http://dx.doi.org/10.1152/physrev.00037.2021
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