Frailty in modern geriatrics and neurology

Aging is accompanied by a significant increase in the number of age-associated diseases, which has a serious impact on the individual and society. Against the background of a steady increase in the number of elderly people, the concept of frailty is now actively used in medicine. It implies increased vulnerability to various health problems associated with a decrease in physiological reserves against the background of aging, including accelerated aging in neurodegeneration. Psychosocial, environmental and age-related biological factors contribute to the decline in physical and cognitive abilities. Their culmination leads to the condition known as physical frailty, in addition to which a lot of researchers are emphasizing the phenomenon of cognitive frailty as a manifestation of cognitive impairment on the background of increasing physical weakness. The review presents an up-to-date analysis of the literature on frailty as a multidimensional and dynamic process, focusing on the role of cognitive reserve in aging. Evidence from cross-sectional and longitudinal studies is reviewed, showing that cognitive frailty is associated with increased risk of disability, impaired quality of life, hospitalizations, mortality, and neurocognitive disorders. This emphasizes the importance of introducing this concept into the clinical practice of geriatricians and neurologists. The article reviews data on the epidemiology, diagnostic approaches used, and perspectives.