What is the Origin of Physical Frailty?

The term 'frailty' originates from the Latin fragilitas, meaning "brittleness" or "weakness." In the clinical context, it has evolved into a specific, quantifiable geriatric syndrome distinct from simple comorbidity or disability. Its connection to endocrinology is highlighted by the recognition of sarcopenia and chronic inflammation as key biological drivers, both of which are highly sensitive to hormonal status.

What is the Mechanism of Physical Frailty?

The physiological mechanism of physical frailty is multifactorial, involving chronic low-grade inflammation, cumulative cellular damage, and a progressive decline in anabolic hormonal signaling. Age-related reduction in growth hormone and sex steroids impairs muscle protein synthesis, leading to sarcopenia and reduced strength. Furthermore, chronic stress and HPA axis dysregulation contribute to a catabolic state by sustaining elevated cortisol levels, which accelerate muscle and bone breakdown. This systemic imbalance of anabolic and catabolic signals diminishes the body's capacity to respond effectively to stressors, culminating in the clinical manifestation of frailty.

Physical Frailty

Meaning

Physical frailty is a clinical syndrome characterized by a measurable decline in physiological reserve and function across multiple organ systems, resulting in increased vulnerability to adverse health outcomes, including falls, disability, and mortality. It is defined by the presence of several criteria, such as unintentional weight loss, self-reported exhaustion, low grip strength, slow walking speed, and low physical activity. Frailty is often closely linked to endocrine aging, specifically the decline in anabolic hormones like testosterone, estrogen, and growth hormone, alongside dysregulation of the HPA axis. Addressing underlying hormonal deficits is a critical strategy in mitigating the progression of this syndrome.