Skip to main content

Advertisement

Log in

Frailty, Successful Aging, Resilience, and Intrinsic Capacity: a Cross-disciplinary Discourse of the Aging Process

  • Frailty in the Elderly (TP NG, Section Editor)
  • Published:
Current Geriatrics Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The relationship between successful aging, frailty, intrinsic capacity, and resilience is explored, in terms of underlying physiology, indicators, and utility.

Recent Findings

Frailty may be regarded as the reverse of successful aging conceptually, but more appropriate for clinical management and health promotion programs. Intrinsic capacity may be used as indicator of healthy aging, and the concept of resilience more relevant in research efforts to understand the heterogeneous age-related changes. In prevention of geriatric syndromes and diseases, as well as in the formulation of health policies, the use of a negative undesirable state (such as frailty) may elicit more response than the alternative approach of maintaining intrinsic capacity. For example, smoking cessation strategies heavily use negative images, as opposed to “maintaining good lung function.” Similarly, in hospital management, frailty assessment has rapidly become incorporated into management in various specialties such as cardiology, renal medicine, and oncology, in addition to Geriatric Medicine and primary care.

Summary

Successful aging, frailty, resilience, and intrinsic capacity share many common features; the use of these terms represents different approaches towards describing age-related changes at all levels: from cellular, physiological systems, to whole persons and community.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. Fougere B. Linda Fried ICFSR life achievement award: the 12 major advances in the field of frailty. USA: ICFSR; 2018.

    Google Scholar 

  2. Woo J. Challenges of population ageing: putting frailty as a cornerstone of health and social care systems. Eur Geriatr Med. 2018;9(3):273–6. https://doi.org/10.1007/s41999-018-0056-0.

    Article  Google Scholar 

  3. Dent E, Lien C, Lim WS, Wong WC, Wong CH, Ng TP, et al. The Asia-Pacific clinical practice guidelines for the management of frailty. J Am Med Dir Assoc. 2017;18(7):564–75. https://doi.org/10.1016/j.jamda.2017.04.018.

    Article  PubMed  Google Scholar 

  4. Archibald MM, Ambagtsheer R, Beilby J, Chehade MJ, Gill TK, Visvanathan R, et al. Perspectives of frailty and frailty screening: protocol for a collaborative knowledge translation approach and qualitative study of stakeholder understandings and experiences. BMC Geriatr. 2017;17:87. https://doi.org/10.1186/s12877-017-0483-7.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Warmoth K, Lang IA, Phoenix C, Abraham C, Andrew MK, Hubbard RE, et al. ‘Thinking you're old and frail’: a qualitative study of frailty in older adults. Ageing Soc. 2016;36(7):1483–500. https://doi.org/10.1017/S0144686x1500046x.

    Article  Google Scholar 

  6. WHO. WHO Clinical Consortium on Healthy Ageing 2017 - report of consortium meeting 21 and 22 November 2017 in Geneva, Switzerland. Licence: CC BY-NC-SA 3.0 IGO. Switzerland: World Health organization; 2017.

    Google Scholar 

  7. Cesari M, Araujo de Carvalho I, Amuthavalli Thiyagarajan J, Cooper C, Martin FC, Reginster JY, et al. Evidence for the domains supporting the construct of intrinsic capacity. J Gerontol A Biol Sci Med Sci. 2018;73:1653–60. https://doi.org/10.1093/gerona/gly011.

    Article  PubMed  Google Scholar 

  8. Huber M, Knottnerus JA, Green L, van der Horst H, Jadad AR, Kromhout D, et al. How should we define health? Brit Med J. 2011;343:D4163. https://doi.org/10.1136/Bmj.D4163.

    Article  PubMed  Google Scholar 

  9. •• Rowe JW, Kahn RL. Successful aging. Gerontologist. 1997;37(4):433–40. https://doi.org/10.1093/geront/37.4.433 This study discusses the relationship between frailty and successful aging.

    Article  CAS  PubMed  Google Scholar 

  10. Bowling A. Aspirations for older age in the 21st century: what is successful aging? Int J Aging Hum Dev. 2007;64(3):263–97. https://doi.org/10.2190/L0k1-87w4-9r01-7127.

    Article  PubMed  Google Scholar 

  11. Woo J, Leung J, Zhang T. Successful aging and frailty: opposite sides of the same coin? J Am Med Dir Assoc. 2016;17(9):797–801. https://doi.org/10.1016/j.jamda.2016.04.015.

    Article  PubMed  Google Scholar 

  12. Conti AA, Conti A. Frailty and resilience from physics to medicine. Med Hypotheses. 2010;74(6):1090. https://doi.org/10.1016/j.mehy.2010.01.030.

    Article  PubMed  Google Scholar 

  13. •• Hayman KJ, Kerse N, Consedine NS. Resilience in context: the special case of advanced age. Aging Ment Health. 2017;21(6):577–85. https://doi.org/10.1080/13607863.2016.1196336 This is a key paper introducing the concept of physical resilience.

    Article  PubMed  Google Scholar 

  14. Ng TP. Resilience and successful ageing among older Singaporeans: Singapore Longitudinal Ageing Study. Asian Pacific Rim Universities Conference, Singapore Oct 11, 2017.

  15. Whitson HE, Duan-Porter W, Schmader KE, Morey MC, Cohen HJ, Colon-Emeric CS. Physical resilience in older adults: systematic review and development of an emerging construct. J Gerontol A Biol Sci Med Sci. 2016;71(4):489–95. https://doi.org/10.1093/gerona/glv202.

    Article  PubMed  Google Scholar 

  16. Miller BF, Seals DR, Hamilton KL. A viewpoint on considering physiological principles to study stress resistance and resilience with aging. Ageing Res Rev. 2017;38:1–5. https://doi.org/10.1016/j.arr.2017.06.004.

    Article  PubMed  Google Scholar 

  17. Felten BS, Hall JM. Conceptualizing resilience in women older than 85: overcoming adversity from illness or loss. J Gerontol Nurs. 2001;27(11):46–53.

    Article  CAS  PubMed  Google Scholar 

  18. Ferrucci L, Giallauria F, Schlessinger D. Mapping the road to resilience: novel math for the study of frailty. Mech Ageing Dev. 2008;129(11):677–9. https://doi.org/10.1016/j.mad.2008.09.007.

    Article  PubMed  PubMed Central  Google Scholar 

  19. De Alfieri W, Borgogni T. Through the looking glass and what frailty found there: looking for resilience in older adults. J Am Geriatr Soc. 2010;58(3):602–3. https://doi.org/10.1111/j.1532-5415.2010.02754.x.

    Article  PubMed  Google Scholar 

  20. De Alfieri W, Costanzo S, Borgogni T. Biological resilience of older adults versus frailty. Med Hypotheses. 2011;76(2):304–5. https://doi.org/10.1016/j.mehy.2010.11.028.

    Article  PubMed  Google Scholar 

  21. Boers M, Cruz Jentoft AJ. A new concept of health can improve the definition of frailty. Calcif Tissue Int. 2015;97(5):429–31. https://doi.org/10.1007/s00223-015-0038-x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Witham MD, Sayer AA. Biological resilience in older people - a step beyond frailty? Eur Geriatr Med. 2015;6(2):101–2. https://doi.org/10.1016/j.eurger.2014.12.008.

    Article  Google Scholar 

  23. •• Rockwood K, Mitnitski A. Resilience and frailty: further steps, best taken together. Eur Geriatr Med. 2015;6(5):405–7. https://doi.org/10.1016/j.eurger.2015.06.001 This is a paper exploring the underlying physiology between physical resilience and frailty.

    Article  Google Scholar 

  24. Varadhan R, Seplaki CL, Xue QL, Bandeen-Roche K, Fried LP. Stimulus-response paradigm for characterizing the loss of resilience in homeostatic regulation associated with frailty. Mech Ageing Dev. 2008;129(11):666–70. https://doi.org/10.1016/j.mad.2008.09.013.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Varadhan R, Walston JD, Bandeen-Roche K. Can a link be found between physical resilience and frailty in older adults by studying dynamical systems? J Am Geriatr Soc. 2018;66:1455–8. https://doi.org/10.1111/jgs.15409.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Gijzel SMW, van de Leemput IA, Scheffer M, Roppolo M, Rikkert MGMO, Melis RJF. Dynamical resilience indicators in time series of self-rated health correspond to frailty levels in older adults. J Gerontol A-Biol. 2017;72(7):991–6. https://doi.org/10.1093/gerona/glx065.

    Article  Google Scholar 

  27. Rebagliati GA, Sciume L, Iannello P, Mottini A, Antonietti A, Caserta VA, et al. Frailty and resilience in an older population. The role of resilience during rehabilitation after orthopedic surgery in geriatric patients with multiple comorbidities. Funct Neurol. 2016;31(3):171–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Martin CM. Self-rated health: patterns in the journeys of patients with multi-morbidity and frailty. J Eval Clin Pract. 2014;20(6):1010–6. https://doi.org/10.1111/jep.12133.

    Article  PubMed  Google Scholar 

  29. •• D’Avanzo B, Shaw R, Riva S, Apostolo J, Bobrowicz-Campos E, Kurpas D, et al. Stakeholders' views and experiences of care and interventions for addressing frailty and pre-frailty: a meta-synthesis of qualitative evidence. PLoS One. 2017;12(7):e0180127. https://doi.org/10.1371/journal.pone.0180127 This is the first paper to introduce the concept of intrinsic capacity promoted by the World Health Organization, as well as proposed indicators of intrinsic capacity in each of the five domains.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Lipsitz LA. Dynamic models for the study of frailty. Mech Ageing Dev. 2008;129(11):675–6. https://doi.org/10.1016/j.mad.2008.09.012.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Levine ME. Modeling the rate of senescence: can estimated biological age predict mortality more accurately than chronological age? J Gerontol A Biol Sci Med Sci. 2013;68(6):667–74. https://doi.org/10.1093/gerona/gls233.

    Article  PubMed  Google Scholar 

  32. Li Q, Wang S, Milot E, Bergeron P, Ferrucci L, Fried LP, et al. Homeostatic dysregulation proceeds in parallel in multiple physiological systems. Aging Cell. 2015;14(6):1103–12. https://doi.org/10.1111/acel.12402.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Cohen AA, Milot E, Li Q, Bergeron P, Poirier R, Dusseault-Belanger F, et al. Detection of a novel, integrative aging process suggests complex physiological integration. PLoS One. 2015;10(3):e0116489. https://doi.org/10.1371/journal.pone.0116489.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jean Woo.

Ethics declarations

Conflict of Interest

J Woo declares no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Frailty in the Elderly

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Woo, J. Frailty, Successful Aging, Resilience, and Intrinsic Capacity: a Cross-disciplinary Discourse of the Aging Process. Curr Geri Rep 8, 67–71 (2019). https://doi.org/10.1007/s13670-019-0276-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13670-019-0276-2

Keywords

Navigation