Sistema de Salut de Catalunya
Institut Català de la Salut
[Bellelli G] School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. Acute Geriatric Unit, IRCCS Foundation San Gerardo, Monza, Italy. [Triolo F] Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. [Ferrara MC] School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. [Deiner SG] Department of Anesthesiology, Dartmouth Health, Lebanon, New Hampshire, USA. [Morandi A] Intermediate Care and Rehabilitation, Azienda Speciale Cremona Solidale, Cremona, Italy. Grup de Recerca en Envelliment, Fragilitat i Transicions a Barcelona, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Parc Sanitari Pere Virgili, Barcelona, Spain. [Cesari M] Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. [Inzitari M] Grup de Recerca en Envelliment, Fragilitat i Transicions a Barcelona, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Parc Sanitari Pere Virgili, Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
Vall d'Hebron Barcelona Hospital Campus
2024-11-07T13:32:58Z
2024-11-07T13:32:58Z
2024-11
Delirium; Frailty; Hallmarks of aging
Delirio; Fragilidad; Características del envejecimiento
Deliri; Fragilitat; Trets distintius de l'envelliment
Frailty and delirium are two common geriatric syndromes sharing several clinical characteristics, risk factors, and negative outcomes. Understanding their interdependency is crucial to identify shared mechanisms and implement initiatives to reduce the associated burden. This literature review summarizes scientific evidence on the complex interplay between frailty and delirium; clinical, epidemiological, and pathophysiological commonalities; and current knowledge gaps. We conducted a PubMed systematic search in June 2023, which yielded 118 eligible articles out of 991. The synthesis of the results-carried out by content experts-highlights overlapping risk factors, clinical phenotypes, and outcomes and explores the influence of one syndrome on the onset of the other. Common pathophysiological mechanisms identified include inflammation, neurodegeneration, metabolic insufficiency, and vascular burden. The review suggests that frailty is a risk factor for delirium, with some support for delirium associated with accelerated frailty. The proposed unifying framework supports the integration and measurement of both constructs in research and clinical practice, identifying the geroscience approach as a potential avenue to develop strategies for both conditions. In conclusion, we suggest that frailty and delirium might be alternative-sometimes coexisting-manifestations of accelerated biological aging. Clinically, the concepts addressed in this review can help approach older adults with either frailty or delirium from a different perspective. From a research standpoint, longitudinal studies are needed to explore the hypothesis that specific pathways within the biology of aging may underlie the clinical manifestations of frailty and delirium. Such research will pave the way for future understanding of other geriatric syndromes as well.
Article
Published version
English
Persones grans; Deliri; Astènia; Envelliment; NAMED GROUPS::Persons::Age Groups::Adult::Aged; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors; DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Frailty; DISEASES::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Neurologic Manifestations::Neurobehavioral Manifestations::Confusion::Delirium; DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::adulto::anciano; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::estadística como asunto::probabilidad::riesgo::factores de riesgo; ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::fragilidad; ENFERMEDADES::afecciones patológicas, signos y síntomas::signos y síntomas::manifestaciones neurológicas::manifestaciones neuroconductuales::confusión::delirio confusional
Wiley
Journal of Internal Medicine;296(5)
https://doi.org/10.1111/joim.20014
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - VHIR [1655]
