Frailty and Sarcopenia: The New Geriatric Giants

In the last decade, it has become clear that older persons who are frail or sarcopenic have very high rates of functional deterioration, hospitalization, and death. Recently, it has become recognized that simple screening questionnaires, e.g., the FRAIL and SARC-F, perform as well as more complex testing for the physical phenotype screen and sarcopenia. In this article, we provide a simple algorithm for the management of frailty. The multiple factors responsible for the pathogenesis of sarcopenia are reviewed, focusing on the importance of age-associated loss of motor units innervating muscle. Management of sarcopenia includes resistance exercise, leucine-enriched protein, and vitamin D. A number of newer drugs are under development. General practitioners should be encouraged to screen for frailty and sarcopenia in older persons.