HERE IS AN ARTICLE THAT WAS RECENTLY POSTED ON "CONSULTANT 360" THAT IS QUITE FASCINATING, AND I COULD NOT RESIST APPRISING EVERYONE HERE IN THE PODIATRY.COM FORUM OF IT. I AM CERTAIN YOU WILL FIND AT LEAST THE FIRST FEW PARAGRAPHS INTERESTING.
AS SO OFTEN WE ARE THE 'FIRST CONTACT' CLINICIANS WHO END UP REFERRING OUR PATIENTS TO A PCM BECAUSE THEY LACK ONE, HAVE NOT SEEN ONE IN YEARS, AND/OR REQUIRE A PRE-OP H&P, IT IS OF COURSE OBVIOUSLY INCUMBENT UPON US THAT WE ARE AWARE OF MAJOR PRESENT & FUTURE CONDITIONS, SYNDROMES, & DIAGNOSES THAT ARE OUT THERE. [WHOA, SORRY FOR THE COMPLEX, COMPOUND SENTENCE JUST THERE... AS ONE WHOM IS SLIGHTLY ADD (MAKES ME A GREAT MULTI-TASKER SO LONG AS I FOCUS & CONCENTRATE), THEY SAY IN THE TECH WRITING WORLD, THE LONGER THE SENTENCE GETS, THE MORE COMPREHENSION GOES DOWN.]
Please note that this condition of "Frailty" is predicted to affected 1.2 billion worldwide and as of yet is described as of yet as being largely a subjective diagnosis.
Frailty: The Forthcoming Medical Crisis
Tue, 09/17/13 - 15:03/ Authors: David T. Nash, MD /Citation: Consultant. 2013;53(9):654-655
> ABSTRACT: Frailty is a medical condition that is increasing in prevalence as we see our worldwide populations age. Defined as a state of increased vulnerability to psychological and multisystem stressors, faility is a clinical syndrome with multiple pathologies. A collaborative approach between primary care practitioners, and specialists in cognitive impairment, neurological dysfunctions and genetics, is needed to define the criteria, diagnosis and treatment for the condition.
By 2025, there will be 1.2 billion frail individuals in the world, 75% of which live in developing nations, according to WHO data.1 As such, frailty is evolving into a medical care challenge that will increase dramatically within a single generation. In the United States, individuals over the age of 80 represent the fastest growing population segment.1
> WHAT IS FRAILTY?
Frailty is defined as: “A state of increased vulnerability to stressors that result from decreased physiological reserves and multi-system dysregulation, limited capacity to maintain homeostasis and to respond to internal and external stressors. Fragility is an aggregate expression of risk resulting from age or disease related physiologic accumulations of subthreshold decrements affecting multiple physiologic systems resulting in adverse health outcomes.”2
Frailty is a clinical syndrome characterized by multiple pathologies: weight loss, fatigue, weakness, low activity, slow motor performance, and balance and gait abnormalities. Central to the frailty definition is the concept that multiple systems must be involved—including neuromuscular, endocrine, and immune systems—in an aging individual. Low-level inflammation, sarcopenia, nutritional, and environmental stresses can be involved.
While there is no single consensus on the number or the intensity of the charactersitics of fraility, there are enough insights on the disease to plan treatment strategies and examine risk factors contributing to the diagnosis. Clinicians use a “I’ll know it when I see it” approach.
The loss of muscle mass and strength with aging—referred to as sarcopenia—is highly prevalent and predicts several adverse outcomes. Increased levels of apoptosis have been reported in elderly animal studies, as well as an increased focus on the role of mitochondria.3 Caloric restriction and physical exercise may be therapeutically beneficial treatment options to be tested in a controlled study.
> CAUSES OF FRAILTY
• Chronic inflammation...
• Low grade elevations in the levels of circulating pro-inflammatory markers, including tumor necrosis factor alpha (TNF-α) and interleukin (IL-6), are strong independent risk factors of morbidity in the elderly.5 Frailty in elderly...
> ASSOCIATIVE CONDITIONS...
o Cardiovascular disease.
o Insulin Resistance.
> LESSONING THE IMPACT OF FRAILTY...
> FUTURE RESEARCH...
Read the rest of the ommitted article at:
Killer article, huh?!
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