frailty

Fractures in the elderly result in significant dysfunction, with many not recovering their full function, with up to 25% requiring permanent institutional care and an eightfold increase in mortality within three months of a hip fracture. Treatment has been directed at strengthening bone with Vitamin D and calcium as well as assistance in ambulation and balance. A new paper brings an engineering perspective to the issue comparing structure fatigue to bone “fatigue;” suggesting that upwards to 25% of these fractures represent bone fragility or what I term orthopedic frailty.

Besides providing an interior structure for our bodies, so that we are not amorphous masses, bone serves to anchor our muscles and form levers with our joints, that help us stand and walk. Beneath the surface...

Physicians, especially surgeons, to provide meaningful information to patients continue to look for risk factors associated with complications and death. Everyone has a story of successfully operating on a 90-year-old, “but there were a ‘good’ 90-year-old.” As the population ages, defining a ‘good 90-year-old’ becomes more critical. A meta-analysis in BMC Medicine suggests, age is too coarse a measure, but dimensions of cognitive and physical impairment are more predictive.

The authors used a literature review of English language articles on risk factors and subsequent complications, deaths, loss of functional abilities and post-discharge care identifying 44 studies involving 12,281 patients...