【Health Lecture】Aging Frailty - The Silent Health "Killer"

In order to ensure the popularization effect of learning health knowledge in the 3rd China Elderly Health Knowledge Competition, the organizers have collected various health science articles suitable for the elderly to learn from various hospitals. We will share them through the "Health Lecture Hall" column. Today, Wang Xiaohang and Yang Yajuan from the Endoscopy Center of the Second Affiliated Hospital of the Naval Medical University brought us "Senior Frailty - the Quiet Health "Killer"". Elderly friends are welcome to learn. When seeing the word "frailty", most people will think of "neurasthenia". Is this the same thing? I believe most people will ask questions, what is the difference between "frailty" and "senile frailty"? As the problem of aging population in the world becomes increasingly obvious, the size and aging speed of the elderly population in my country rank first in the world, and the impact of the occurrence of diseases in the elderly on families and society has attracted widespread attention. Among the many accompanying symptoms of the elderly, the incidence of frailty in my country is as high as 12.7%, which is higher than the global level. So, what is "senile frailty"? Can we judge it ourselves in daily life? If "senile frailty" exists, what impact will it have on our lives?

1. What is frailty in the elderly?

When people begin to enter old age, the functions of the "various parts" of the human body also begin to gradually decline. In the eyes of many people, this is "old age". In daily life, the elderly may also experience loss of appetite, insomnia and forgetfulness, backache and leg pain, frequent urination at night, cough due to qi deficiency, cold limbs and chills, etc., which are manifestations of senile frailty. There is a set of scientific methods in medicine (the editor will introduce it in detail in a later chapter) that can help judge whether the elderly have frailty. The elderly who are assessed as frail and pre-frail will be included in the ranks of "senile frailty". In recent years, scientific research has found that frailty is not just a physiological phenomenon, but a disease - senile frailty syndrome. Foreign studies have found that one in ten elderly people over 65 years old suffer from frailty syndrome, and frailty may account for a quarter or even half of the elderly over 85 years old. The introduction of frailty can accurately and objectively reflect the health problems of the elderly and their medical needs. In life, if the elderly have unexplained weight loss, obvious fatigue, decreased mobility, or low mood and loss of interest, they should first be alert to senile frailty. For example, an old man retired for 10 years and is now 70 years old. He often feels that his physical strength is getting worse and worse, and he feels tired when doing some things. However, when he was hospitalized for examination, all indicators were within the normal range. In this case, a frailty screening can be done to see if frailty syndrome has occurred. Some elderly people walk slowly, have unstable gait, cannot even cross the threshold, and are prone to falling. There is no cardiovascular and cerebrovascular disease in the hospital examination, so you can also try to do a self-assessment of frailty. Some elderly people show weight loss and malnutrition for no obvious reason. Due to the weakened gastrointestinal absorption function of the elderly and the decline of their own metabolic capacity, the same three meals a day may cause malnutrition and weight loss in frail elderly people. Because of the decline in their own reserve capacity, frail elderly people are prone to some adverse events when there are external stimuli, such as falls and sleep disorders. Therefore, understanding the frailty of the elderly can help us detect and identify it scientifically at an early stage, treat it as soon as possible, and prevent it symptomatically.

2. Impact of frailty on individuals and families

What kind of impact will frailty have on the health of the elderly? First of all, frailty will cause a significant decrease in the stress response capacity of the elderly. For example, frail elderly people are like "paper tigers". They seem to have no problems on the outside, but when there is a little external stimulation, there is a high probability that a series of extended problems will occur. For example, the elderly's thighs and feet are not very flexible, and they accidentally fall and fracture, and are hospitalized for surgery. As a result, due to the poor nutritional status of the elderly and limited activities after getting out of bed after surgery, they have to stay in bed for a long time, have a prolonged recovery time, and increase the chance of lung infection. This not only brings great inconvenience to the elderly, but also increases the corresponding economic and care burden on his family and society. Moreover, although the fractures of frail elderly people heal, their physical condition may never return to the state before the fracture after this blow.

Secondly, frailty will lead to increased complications and poor recovery in the elderly with some underlying diseases. Generally speaking, frailty in the elderly is interrelated with many types of diseases. The decline in muscle strength, gastrointestinal function and other functions of the elderly leads to the occurrence of basic diseases such as diabetes and hypertension. In turn, the occurrence of diseases will make the elderly more "fragile". Japanese medical experts have found that among the elderly over 65 years old, if hypertension is not well controlled, the incidence of frailty will increase. For elderly patients with cardiovascular diseases who have frailty, complications will increase significantly, outpatient visits and hospitalizations will increase, hospital stays will be prolonged, and mortality will increase. Among elderly diabetic patients over 65 years old, the incidence of frailty is 4-6 times that of elderly people without diabetes. It can be seen that frailty in the elderly affects each other with various diseases. Thirdly, frailty in the elderly is also related to mental illness. Frailty in the elderly also has symptoms of neurasthenia, such as the efficiency of doing things will gradually decrease, often forget things, often say wrong things, can't remember what has just happened, and the early symptoms of senile dementia are similar. At the same time, they are also prone to emotional instability, sleep disorders, sensitivity and suspicion, etc. The more severe the frailty, the higher the risk of depression in the elderly. Therefore, for the elderly, early detection of frailty, early diagnosis, early prevention, and early treatment are also beneficial for society and families to provide early guidance and help for the mental and psychological health of the elderly to avoid adverse events. From the above situation, it is not difficult to find that the probability of frailty in the elderly accompanied by various diseases cannot be ignored. Various adverse events that occur during the elderly's home life not only affect the lives of the elderly, but also bring various problems to the entire family. Early detection and timely prevention are our active response and solution methods.

About the first author:

Wang Xiaohang is the head nurse and deputy chief nurse of the Endoscopy Center of the Second Affiliated Hospital of the Naval Medical University. She is currently mainly engaged in clinical nursing and nursing management related to digestive system diseases and endoscopic diagnosis and treatment. She is a member of the Nursing Collaboration Group of the Digestive Disease Branch of the Chinese Medical Association, a member of the Digestive Endoscopy Nursing Committee of the 12th Council of the Shanghai Nursing Association, and a member of the Nursing Group of the 9th Committee of the Endoscopy Branch of the Shanghai Medical Association. Since she started working, she has published 22 papers in core journals, including 15 as the first author and 7 as the corresponding author; she has edited and participated in 15 books and 2 textbooks for the "12th Five-Year Plan"; she has undertaken 5 nursing project funds at the hospital and municipal levels; and the first finisher won 1 "Third Prize for Military Medical Achievements".