[ExI] [GRG] NewAbs: Frailty Is a Biomarker for Death

[M2darwin at aol.com]

In a message dated 6/18/2013 11:05:36 P.M. Pacific Daylight  Time, 
scoles at grg.org writes:

Everyone older than  70 should be checked for frailty, a condition that is 
both easily treated and  potentially deadly, according to an article by 
representatives from six major  international and U.S. medical organizations 
(see also  Gerontology). 
They've got to be kidding when they write that, "frailty...is  both easily 
treated and potentially deadly"! Really?! 
 
Frailty is a clinical sign of impending end stage  multi-system failure. As 
such, it is virtually impossible to treat, let  alone to easily treat.
 
As the authors note, the typical elderly frail person presents  with at 
least the following pathologies in an advanced state and flagrantly  evident:
 
* sarcopenia: as evidenced by dramatically reduced muscle  mass, weakness 
and difficulty moving loads - most cannot push a chair across a  room!
 
* grave compromise of the CNS: as evidenced by difficulty  maintaining 
balance, altered gait (the old man or old woman shuffle),  apathy, lack of 
motivation/interest (with or without clinically  evident depression), and loss of 
fluid movements in bending, reaching for  objects or rising from a sitting 
or recumbent position. These signs almost  invariably signal some degree of 
cognitive comprise, the extent of which can be  difficult to determine 
absent spending some meaningful amount of time  interviewing the patient and 
asking the right questions. There is almost  invariably marked cerebral atrophy 
and/or the presence of disseminated  cerebrovascular disease,
 
* inappetance and malnutrition which often signal loss of  olfactory 
receptors and their associated sensory neurons,
 
* major loss of bone mass due to both organic osteoporosis and  additional 
loss of bone mass from decreased mobility and load  bearing.
 
The classically frail elderly individual is a person  drained of organic 
reserves in virtually every major organ system. They  are not just "unfit" or 
"malnourished"  - indeed, if you use any  reasonably rigorous objective 
laboratory measurements, there will be ample  evidence of low or negligible 
cardiovascular, musculoskeletal, cerebral, renal  and immune reserves. Thus, 
frailty might be fairly described as  the "penultimate one hoss shay of human 
aging," with super  centenartians being the ultimate one hoss shay. 
 
While I understand why gerontologists are interested in super  centenarians 
and the longevity genes and lifestyle(s) which permit them to reach  such 
an advanced age, the bottom line is that the end product is uniformly  
nightmarish and only preferable when compared to death itself:


 

 
 
These individuals  represent the near perfect definition of "frailty absent 
discrete disease." The  only difference between these poor souls and the 
more common (and much younger)  frail elderly individual is that the typical 
frail old person is usually  afflicted with multiple, discrete pathologies. 
While the frailty of super  centenarians does indeed translate into more 
"well and productive years," it is  critically important to understand that the 
end product is nothing more or  less than distilled senescence - i.e., 
biological aging divorced from any  particular, diagnosable disease. As such, 
these individuals represent  not some extraordinary key to avoiding aging, but 
rather, the pathway to dying  of just aging - and nothing else. This may be 
justifiably called  "longevity." But what it is not, and should not be 
mistaken for, is extended  youth. These people lost their youth many decades 
before they lost their  lives; and that is a great tragedy which, it  seems, is 
largely unappreciated  by gerontologists the world  over.
Mike Darwin
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