, Volume 11, Issue 5, pp 547–563 | Cite as

Aging, frailty and age-related diseases

  • T. FulopEmail author
  • A. Larbi
  • J. M. Witkowski
  • J. McElhaney
  • M. Loeb
  • A. Mitnitski
  • G. Pawelec
SI: Frailty, Ageing and Inflammation


The concept of frailty as a medically distinct syndrome has evolved based on the clinical experience of geriatricians and is clinically well recognizable. Frailty is a nonspecific state of vulnerability, which reflects multisystem physiological change. These changes underlying frailty do not always achieve disease status, so some people, usually very elderly, are frail without a specific life threatening illness. Current thinking is that not only physical but also psychological, cognitive and social factors contribute to this syndrome and need to be taken into account in its definition and treatment. Together, these signs and symptoms seem to reflect a reduced functional reserve and consequent decrease in adaptation (resilience) to any sort of stressor and perhaps even in the absence of extrinsic stressors. The overall consequence is that frail elderly are at higher risk for accelerated physical and cognitive decline, disability and death. All these characteristics associated with frailty can easily be applied to the definition and characterization of the aging process per se and there is little consensus in the literature concerning the physiological/biological pathways associated with or determining frailty. It is probably true to say that a consensus view would implicate heightened chronic systemic inflammation as a major contributor to frailty. This review will focus on the relationship between aging, frailty and age-related diseases, and will highlight possible interventions to reduce the occurrence and effects of frailty in elderly people.


Frailty Aging Immunosenescence Chronic diseases Inflamm-aging IRP 



This work was partly supported by the Research Center on Aging, by the Canadian Initiative on Frailty and Aging, by a Canadian Institutes of Health Research (No 63149) grant and the University of Sherbrooke, and by EU-LSHG-CT-2007-036894 “LifeSpan” and DFG-PA 361/14-1 (to GP).


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© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • T. Fulop
    • 1
    Email author
  • A. Larbi
    • 2
    • 9
  • J. M. Witkowski
    • 3
  • J. McElhaney
    • 4
    • 5
  • M. Loeb
    • 6
    • 7
  • A. Mitnitski
    • 8
  • G. Pawelec
    • 2
  1. 1.Research Center on Aging, Immunology Program, Geriatric Division, Faculty of MedicineUniversity of SherbrookeSherbrookeCanada
  2. 2.Tübingen Ageing and Tumour Immunology Group, Center for Medical ResearchUniversity of Tübingen Medical SchoolTübingenGermany
  3. 3.Department of PathophysiologyMedical University of GdańskGdańskPoland
  4. 4.Department of Immunology, Center for Immunotherapy of Cancer and Infectious Diseases, MC 1601University of Connecticut School of MedicineFarmingtonUSA
  5. 5.Department of MedicineUniversity of British ColumbiaVancouverCanada
  6. 6.Department of Pathology and Molecular MedicineMcMaster UniversityHamiltonCanada
  7. 7.Department Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada
  8. 8.Department of MedicineDalhousie UniversityHalifaxCanada
  9. 9.Singapore Immunology Network (SIgN)BiopolisSingapore

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