Skip to main content
Top

Open Access 05-10-2024 | Sarcopenia | Commentary

The under-recognition and significance of frailty syndrome – a geriatric and forensic conundrum

Author: Roger W. Byard

Published in: Forensic Science, Medicine and Pathology

Login to get access

Abstract

Frailty syndrome occurs in elderly individuals with declining muscle mass (sarcopenia), unintentional weight loss, decreasing physical strength and activity, exhaustion, and slow ambulation. It significantly increases morbidity and mortality with cardiovascular, renal disease and neurological disorders, osteoporosis and fractures, endocrine and immunological dysfunction and a variety of malignancies. It is increasing in incidence as the population ages. However, unfortunately as identification relies on clinical and not pathological evaluations, its contribution to a wide range of comorbidities and its role in terminal episodes may not be recognized in a forensic context.
Literature
2.
go back to reference Byard RW. Frailty syndrome – medicolegal considerations. J Forensic Leg Med. 2015;30 C:34–8.CrossRef Byard RW. Frailty syndrome – medicolegal considerations. J Forensic Leg Med. 2015;30 C:34–8.CrossRef
3.
go back to reference Zhang W, Zhou L, Zhou Y, et al. The correlation between frailty trajectories and adverse outcomes in older patients: a systematic review. Arch Gerontol Geriatr. 2024;128:105622.CrossRefPubMed Zhang W, Zhou L, Zhou Y, et al. The correlation between frailty trajectories and adverse outcomes in older patients: a systematic review. Arch Gerontol Geriatr. 2024;128:105622.CrossRefPubMed
4.
go back to reference James K, Jamil Y, Kumar M, et al. Frailty and cardiovascular health. J Am Heart Assoc. 2024;13:031736.CrossRef James K, Jamil Y, Kumar M, et al. Frailty and cardiovascular health. J Am Heart Assoc. 2024;13:031736.CrossRef
5.
go back to reference Nates JL, Pène F, Darmon M, et al. Septic shock in the immunocompromised cancer patient: a narrative review. Investigators Crit Care. 2024;28:285.CrossRefPubMed Nates JL, Pène F, Darmon M, et al. Septic shock in the immunocompromised cancer patient: a narrative review. Investigators Crit Care. 2024;28:285.CrossRefPubMed
6.
go back to reference Heuberger RA. The frailty syndrome: a comprehensive review. J Nutr Gerontol Geriatr. 2011;30:315–68.CrossRefPubMed Heuberger RA. The frailty syndrome: a comprehensive review. J Nutr Gerontol Geriatr. 2011;30:315–68.CrossRefPubMed
7.
go back to reference Rockwood K, Stadnyk K, MacKnight C, McDowell I, Hebert R, Hogan DB. A brief clinical instrument to classify frailty in elderly people. Lancet. 1999;353:205–6.CrossRefPubMed Rockwood K, Stadnyk K, MacKnight C, McDowell I, Hebert R, Hogan DB. A brief clinical instrument to classify frailty in elderly people. Lancet. 1999;353:205–6.CrossRefPubMed
9.
go back to reference Sternberg SA, Wershof Schwartz A, Karunananthan S, Bergman H, Clarfield AM. The identification of frailty: a systematic literature review. J Am Geriatr Soc. 2011;59:2129–38.CrossRefPubMed Sternberg SA, Wershof Schwartz A, Karunananthan S, Bergman H, Clarfield AM. The identification of frailty: a systematic literature review. J Am Geriatr Soc. 2011;59:2129–38.CrossRefPubMed
10.
go back to reference Fulop T, Larbi A, Witkowski JM, et al. Aging, frailty and age-related diseases. Biogerontology. 2010;11:547–63.CrossRefPubMed Fulop T, Larbi A, Witkowski JM, et al. Aging, frailty and age-related diseases. Biogerontology. 2010;11:547–63.CrossRefPubMed
16.
go back to reference Shamliyan T, Talley KMC, Ramakrishnan R, Kane RL. Association of frailty with survival: a systematic literature review. Ageing Res Rev. 2013;12:719–36.CrossRefPubMed Shamliyan T, Talley KMC, Ramakrishnan R, Kane RL. Association of frailty with survival: a systematic literature review. Ageing Res Rev. 2013;12:719–36.CrossRefPubMed
17.
18.
go back to reference Vanitallie TB. Frailty in the elderly: contributions of Sarcopenia and visceral protein depletion. Metabolism. 2003;52(Suppl 2):22–6.CrossRefPubMed Vanitallie TB. Frailty in the elderly: contributions of Sarcopenia and visceral protein depletion. Metabolism. 2003;52(Suppl 2):22–6.CrossRefPubMed
19.
go back to reference Gill TM, Gahbauer EA, Allore HG, Han L. Transitions between frailty states among community-living older persons. Arch Intern Med. 2006;166:418–23.CrossRefPubMed Gill TM, Gahbauer EA, Allore HG, Han L. Transitions between frailty states among community-living older persons. Arch Intern Med. 2006;166:418–23.CrossRefPubMed
20.
go back to reference Gielen E, Verschueren S, O’Neill TW, Pye SR, O’Connell MDL, Lee DM, et al. Musculoskeletal frailty: a geriatric syndrome at the core of fracture occurrence in older age. Calcif Tissue Int. 2012;91:161–77.CrossRefPubMed Gielen E, Verschueren S, O’Neill TW, Pye SR, O’Connell MDL, Lee DM, et al. Musculoskeletal frailty: a geriatric syndrome at the core of fracture occurrence in older age. Calcif Tissue Int. 2012;91:161–77.CrossRefPubMed
22.
go back to reference Mohler MJ, Fain MJ, Wertheimer AM, Najafi B, Nikolich- Zugich J. The frailty syndrome: clinical measurements and basic underpinnings in humans and animals. Exp Gerontol. 2014;54:6–13.CrossRefPubMed Mohler MJ, Fain MJ, Wertheimer AM, Najafi B, Nikolich- Zugich J. The frailty syndrome: clinical measurements and basic underpinnings in humans and animals. Exp Gerontol. 2014;54:6–13.CrossRefPubMed
23.
go back to reference Byard RW. Forensic issues at the extremes of weight: from frailty syndrome through frail obesity to morbid obesity. J Forensic Leg Med. 2015;35:38–9.CrossRefPubMed Byard RW. Forensic issues at the extremes of weight: from frailty syndrome through frail obesity to morbid obesity. J Forensic Leg Med. 2015;35:38–9.CrossRefPubMed
24.
go back to reference Johannesen M, LoGiudice D. Elder abuse: a systematic review of risk factors in community-dwelling elders. Age Ageing. 2013;42:292–8.CrossRefPubMed Johannesen M, LoGiudice D. Elder abuse: a systematic review of risk factors in community-dwelling elders. Age Ageing. 2013;42:292–8.CrossRefPubMed
26.
go back to reference Jang S-N, Chung H-U, Kwon IS, Park SC, Cho S-I. Functional status and calcaneal quantitative ultrasound measurements among the oldest old people living in rural areas of Korea. Arch Gerontol Geriatr. 2009;48:89–94.CrossRefPubMed Jang S-N, Chung H-U, Kwon IS, Park SC, Cho S-I. Functional status and calcaneal quantitative ultrasound measurements among the oldest old people living in rural areas of Korea. Arch Gerontol Geriatr. 2009;48:89–94.CrossRefPubMed
27.
go back to reference Janssen HCJP, Samson MM, Meeuwsen IBAE, Duursma SA, Verhaar HJJ. Strength, mobility and falling in women referred to a geriatric outpatient clinic. Aging Clin Exp Res. 2004;16:122–5.CrossRefPubMed Janssen HCJP, Samson MM, Meeuwsen IBAE, Duursma SA, Verhaar HJJ. Strength, mobility and falling in women referred to a geriatric outpatient clinic. Aging Clin Exp Res. 2004;16:122–5.CrossRefPubMed
28.
go back to reference Frisoli A, Chaves PH, Ingham SJ, Fried LP. Severe osteopenia and osteoporosis, Sarcopenia, and frailty status in community-dwelling older women: results from the women’s health and aging study (WHAS) II. Bone. 2011;48:952–7.CrossRefPubMed Frisoli A, Chaves PH, Ingham SJ, Fried LP. Severe osteopenia and osteoporosis, Sarcopenia, and frailty status in community-dwelling older women: results from the women’s health and aging study (WHAS) II. Bone. 2011;48:952–7.CrossRefPubMed
29.
go back to reference Zhang HT, Tan N, Gao Y, et al. Prediction of postoperative mortality in older surgical patients by clinical frailty scale: a systematic review and meta-analysis. Geriatr Nurs. 2024;59:581–9.CrossRefPubMed Zhang HT, Tan N, Gao Y, et al. Prediction of postoperative mortality in older surgical patients by clinical frailty scale: a systematic review and meta-analysis. Geriatr Nurs. 2024;59:581–9.CrossRefPubMed
30.
go back to reference Partridge JS, Harari D, Dhesi JK. Frailty in the older surgical patient: a review. Age Ageing. 2012;41:142–7.CrossRefPubMed Partridge JS, Harari D, Dhesi JK. Frailty in the older surgical patient: a review. Age Ageing. 2012;41:142–7.CrossRefPubMed
31.
go back to reference Bright F, Winskog C, Gilbert JD, Byard RW. Additional risk factors for lethal hypothermia. J Forensic Leg Med. 2013;20:595–7.CrossRefPubMed Bright F, Winskog C, Gilbert JD, Byard RW. Additional risk factors for lethal hypothermia. J Forensic Leg Med. 2013;20:595–7.CrossRefPubMed
32.
go back to reference Kulmala J, Nykanen I, M € anty M, Hartikainen S. Association between frailty and dementia: a population-based study. Gerontology. 2014;60:16–21.CrossRefPubMed Kulmala J, Nykanen I, M € anty M, Hartikainen S. Association between frailty and dementia: a population-based study. Gerontology. 2014;60:16–21.CrossRefPubMed
33.
go back to reference Kuffel RL, Morin RT, Covinsky KE, et al. Association of frailty with risk of suicide attempt in a national cohort of US veterans aged 65 years or older. JAMA Psychiatry. 2023;80:287–95.CrossRefPubMedPubMedCentral Kuffel RL, Morin RT, Covinsky KE, et al. Association of frailty with risk of suicide attempt in a national cohort of US veterans aged 65 years or older. JAMA Psychiatry. 2023;80:287–95.CrossRefPubMedPubMedCentral
34.
35.
go back to reference Byard RW, Bellis M. Incidence of low body mass index in the elderly in forensic cases - a possible marker for frailty syndrome? J Forensic Sci. 2016;61:676–67.CrossRefPubMed Byard RW, Bellis M. Incidence of low body mass index in the elderly in forensic cases - a possible marker for frailty syndrome? J Forensic Sci. 2016;61:676–67.CrossRefPubMed
36.
go back to reference Byard RW. Morbid obesity and the frailty syndrome. Ch. 33. In: Collins KA, Byard RW, editors. Geriatric forensic Medicine and Pathology. Cambridge: Cambridge University Press; 2020. pp. 589–606.CrossRef Byard RW. Morbid obesity and the frailty syndrome. Ch. 33. In: Collins KA, Byard RW, editors. Geriatric forensic Medicine and Pathology. Cambridge: Cambridge University Press; 2020. pp. 589–606.CrossRef
Metadata
Title
The under-recognition and significance of frailty syndrome – a geriatric and forensic conundrum
Author
Roger W. Byard
Publication date
05-10-2024
Publisher
Springer US
Published in
Forensic Science, Medicine and Pathology
Print ISSN: 1547-769X
Electronic ISSN: 1556-2891
DOI
https://doi.org/10.1007/s12024-024-00900-w