Exercise-Based Interventions as a Management of Frailty Syndrome in Older Populations: Design, Strategy, and Planning

Exercise-based interventions emerged as the best alternative for treating frailty syndrome (FS). Recognized as a complex phenotype, the FS is a multifaceted aging expression determined by biologic, environment, and behaviors factors. The biological theories of human development perceive aging process as an accumulation of harmful biochemical changes, whose occurrence attends the course of life. The progressive losses of functional reserves that occur in the body systems are a hallmark of this negative process. Despite the biological effects of physical and cognitive decline, more contemporary studies have identified that the environmental and behavior factors such as malnutrition and negative psychological adjustment across the life span also contribute to the early appearance of FS. Notwithstanding the latest findings that consistently demonstrate an overall positive benefit of long-term-based exercise in the decrease and/or reversal of the FS with a substantial impact on their correlated outcomes, the focus of this chapter is to present strategies for designing exercise programs for this type of population, taking into account their practical application in the field.

Frailty, Vulnerability, and Plasticity: Towards a New Medicine of Complexity

There is no single way of ageing, but different types of ageotypes have been identified. Frailty is the most problematic expression of the ageing population. The understanding of the route linking ageing, frailty and 2nd order criticalities open new and intriguing operational perspectives. Indeed, frailty might be reversible or attenuated by interventions put in place to avoid its evolution over time. This is most true when traditional therapeutic approaches are combined with the promotion of healthy lifestyles. Not only the European Innovation Partnership on Active and Healthy (EIP-AHA) is actively involved in the promotion of healthy and active ageing, but a more aware geriatric culture toward a new medicine of complexity is spreading. The fight against frailty takes place in a lifespan and multisystemic perspective. Indeed, every individual is a dynamic, interacting, adaptable system in which the disease triggers a cause-and-effect model that cannot be considered linear. Frailty in the elderly requires therefore a customized multidimensional approach according to the principle of “taking care of the patient and not only of the disease”. A bio-psycho-social model can help us to define the most appropriate interventions to promote health in terms of the best possible quality of life.

Reliability and Validity of Clinicopathological Features Associated with Frailty Syndrome in Elderly Population

Geriatrics is an applied science as its practice is an art of medicine. As a scientific discipline, there exists a potential race for measurements. Frailty stands as among poorly defined concepts in geriatric medicine. There are philosophical, circumstantial, and practical justifications behind this rather seemingly clinical tragedy. This chapter contributes toward reliability and validity aspects of currently applied frailty scales and indicators across different population base. It acknowledges the contribution of Fried’s frailty scale. It also describes different frailty scales and indicators tested in America, Europe, and Asia. Lastly, the chapter contrasts the popular belief behind applications of Cronbach’s α coefficient of test scores for reliability assessment in clinical research. Other research gaps are also highlighted including merging clinical research findings in geriatrics with psychosocial aspects under the emerging field of geropsychology. It also proposes a solution for usage in future studies that aim at assessing reliability of test scores in clinical and biomedical sciences.