In Case You Missed It! Frailty Seminar Series presentation on the Progression of Physical Frailty and the Risk of All-Cause Mortality
By Anthony L. Teano, MLA
Communication Specialist
In case you missed it last month, Frailty Science co-PI Dr. Karen Bandeen-Roche delivered an amazing presentation for the Frailty Seminar Series on Physical Frailty and All-Cause Mortality. You can watch the recording here, along with recordings of previous seminars.
Dr. Bandeen-Roche discussed the conceptual case for the relationship between the underpinnings of physical frailty progression and mortality. She also highlighted practical considerations for leveraging frailty as a marker of impending mortality, such as: improvement, and not only progression, often occurs; distinguishing association versus screening and case finding; and algorithmic fairness.
Dr. Bandeen-Roche elucidated that hypothesis that the frailty phenotype reflects a failing dynamical system governing stress response, energy production, and muscle health. Consequently, as systems become more dysregulated, tipping points leading to frailty increasingly are risked. During the Frailty Seminar, Dr. Bandeen-Roche explored key concepts in this phenomenon, such as:
- Robustness/Resilience
- Emergence
- Critical Transition
Pertaining to mortality, the threshold of systemic dysfunction is an important consideration, encompassing severe vulnerability to common stressors. Dr. Bandeen-Roche reports research addressing several hypotheses about the accumulation rate and frequency of frailty criteria particularly to illustrate the “critical transition.” The accumulation of five criteria is evidenced as a milestone in the progression towards all-cause mortality. The rate of frailty onset—catastrophic versus progressive, as well as the frailty dynamics—monotone or fluctuating accumulation—are additional factors.
For a deeper dive into the science, consider reading these great papers on which this talk was based:
Beyond the substantial financial costs associated with chronic wounds (estimated to be between $28-96 billion dollars in Medicare costs in 2018; Nussbaum et al., 2018), the subsequent chronic inflammation and disability arising from such wounds are significant exacerbating factors that limit health-span in older adults. A recent study from a multidisciplinary wound center demonstrated that frailty prevalence, using the deficit accumulation model, was approximately 75% among their patients and wound healing rate was slower in frail individuals (Espaulella-Ferrer et al., 2021). Continue Reading 
