Frailty defined by deficit accumulation and geriatric medicine defined by frailty

Abstract

As nonreplicative cells age, they commonly accumulate subcellular deficits that can compromise function. As people age, they too experience problems that can accumulate. As deficits (symptoms, signs, illnesses, disabilities) accumulate, people become more susceptible to adverse health outcomes, including worse health and even death. This state of increased risk of adverse health outcomes is indistinguishable from the idea of frailty, so deficit accumulation represents another way to define frailty. Counting deficits not only allows grades of frailty to be discerned but also provides insights into the complex problems of older adults. This process is potentially useful to geriatricians who need to be experts in managing complexity. A key to managing complexity is through instruments such as a comprehensive geriatric assessment, which can serve as the basis for routine clinical estimation of an individual's degree of frailty. Understanding people and their needs as deficits accumulate is an exciting challenge for clinical research on frailty and its management by geriatricians.