Frailty and Sarcopenia in Primary Care: Current Issues

Abstract

Frailty consists of an age-related multi-system reduction in reserve capacity that begins early and continues progressively throughout life. The term sarcopenia is used to describe the pathologic age-related loss of muscular mass and strength. These conditions, which are often overlapping, have a multifactorial origin, involving lifestyle habits, disease triggers, and age-dependent biological changes. In this chapter we will describe frailty and sarcopenia and how they are assessed and treated in primary care setting. Family physicians are often the first to experience frailty and sarcopenia because of their long-term relationship with patients. In addition, family physicians are ideally positioned to evaluate and manage frailty among their patients and family caregivers, who may be frail too. Because increased frailty and sarcopenia are associated with increased vulnerability to poor outcomes, early detection may provide an opportunity to prevent or minimize the disabling cascade and to maintain the level of dependence. The new conceptual model physical frailty and sarcopenia (PF&S) that was identified to describe a pre-disability age-related condition in which functional impairment is the common core will be presented at the end of the chapter. The dissection of the inflammatory profile of people with PF&S will provide new insights into the role inflammation plays in the disabling cascade and will improve the design of treatment strategies tailored to the patient.