Psychological intervention

Gerontology

Conceptualization

Gene

Transition (genetics)

Biology

Psychological resilience

Computer security

Psychiatry

Biochemistry

Computer science

Vulnerability (computing)

Psychology

Psychotherapist

Artificial intelligence

Medicine

Clinical psychology

Perspective (graphical)

Stressor

Symphony

Art history

Frailty Index

History

Nature Aging

Frailty in aging marks a state of decreased reserves resulting in increased vulnerability to adverse outcomes when exposed to stressors. This Perspective synthesizes the evidence on the aging-related pathophysiology underpinning the clinical presentation of physical frailty as a phenotype of a clinical syndrome that is distinct from the cumulative-deficit-based frailty index. We focus on integrating the converging evidence on the conceptualization of physical frailty as a state, largely independent of chronic diseases, that emerges when the dysregulation of multiple interconnected physiological and biological systems crosses a threshold to critical dysfunction, severely compromising homeostasis. Our exegesis posits that the physiology underlying frailty is a critically dysregulated complex dynamical system. This conceptual framework implies that interventions such as physical activity that have multisystem effects are more promising to remedy frailty than interventions targeted at replenishing single systems. We then consider how this framework can drive future research to further understanding, prevention and treatment of frailty, which will likely preserve health and resilience in aging populations.

The physical frailty syndrome as a transition from homeostatic symphony to cacophony