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Published in: European Journal of Ageing 2/2019

Open Access 01-06-2019 | Review

On frail minds: addressing and assessing age-related neural decline and disease

Author: David M. Lyreskog

Published in: European Journal of Ageing | Issue 2/2019

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Abstract

The terminology surrounding frailty is used in clinical settings, and in research and development for identifying processes of, and patients in, age-related physical decline. However, a framework suitable for age-related neurodegenerative diseases needs to (1) adequately account for the effects that the processes of aging have on neural decline and disease, and (2) be helpful in identifying relevant groups of users and patients. This is becoming increasingly necessary due to emerging possibilities to detect, prevent, and treat age-related neural decline and disease. Based on a number of relevant criteria, I distinguish four groups of patients and users: robust, non-frail, pre-frail, and frail. With the four groups defined, ethical assessments can be made on an individual basis regarding which medical technologies are best suited for a person who risks, or suffers from, age-related neurodegenerative disease.
Footnotes
1
The term “biomarker” here meaning “a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention” (Wagner et al. 2007).
 
2
Let me state clearly that none of the authors claimed that their terminologies could account for cases of neural decline and disease.
 
3
The concept of risk, and its relation to vulnerability, is highly relevant in the context of frailty. How we conceive of frail populations, e.g., as being vulnerable to and/or at risk of suffering from a set of conditions, rather than actually suffering from any of them, can and should arguably affect the structure of decision-making processes. The limited scope of this paper unfortunately prevents a fair exploration of related issues.
 
Literature
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go back to reference Rodríguez-Mañas L, Féart C, Mann G, Viña J, Chatterji S, Chodzko-Zajko W, Vega E (2013) Searching for an operational definition of frailty: a Delphi method based consensus statement. The frailty operative definition-consensus conference project. J Gerontol Ser A Biol Sci Med Sci 68(1):62–67. https://doi.org/10.1093/gerona/gls119 CrossRef Rodríguez-Mañas L, Féart C, Mann G, Viña J, Chatterji S, Chodzko-Zajko W, Vega E (2013) Searching for an operational definition of frailty: a Delphi method based consensus statement. The frailty operative definition-consensus conference project. J Gerontol Ser A Biol Sci Med Sci 68(1):62–67. https://​doi.​org/​10.​1093/​gerona/​gls119 CrossRef
Metadata
Title
On frail minds: addressing and assessing age-related neural decline and disease
Author
David M. Lyreskog
Publication date
01-06-2019
Publisher
Springer Netherlands
Published in
European Journal of Ageing / Issue 2/2019
Print ISSN: 1613-9372
Electronic ISSN: 1613-9380
DOI
https://doi.org/10.1007/s10433-018-0481-4

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