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Conceptualizing Biological Aging and Frailty in Orthopaedics: A Framework for Clinical Practice
Ting Cong1, Arielle J Hall2, Zhimeng Jia3
1Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, NY.
The Journal of Bone and Joint Surgery. American Volume
|March 11, 2022
Summary
Biological aging is a combination of frailty, comorbidity, and disability. Understanding biological age beyond chronological age is crucial for clinical and surgical decisions, as individuals age differently.
Area of Science:
- Gerontology and clinical medicine
- Understanding the multifaceted nature of aging
Background:
- Chronological age is a standard metric, but biological aging varies significantly between individuals.
- Advancements in senescence research highlight the limitations of chronological age as a sole indicator of biological age.
- Clinical conceptualization of biological aging involves frailty, comorbidity, and disability.
Purpose of the Study:
- To emphasize the clinical utility of assessing biological age beyond chronological age.
- To highlight the importance of a multifactorial approach to understanding aging in patient care.
Main Methods:
- Conceptualizing biological aging through its clinical components: frailty, comorbidity, and disability.
- Analyzing the discrepancy between chronological and biological aging rates.
- Defining frailty as a physical phenotype.
Main Results:
- Biological aging is not uniform and can be clinically assessed by frailty, comorbidity, and disability.
- Frailty is best understood as a physical phenotype.
- Individual aging rates differ, making chronological age an insufficient sole predictor.
Conclusions:
- Practitioners should consider biological age, encompassing frailty, comorbidity, and disability, over chronological age for informed clinical and surgical decisions.
- Physical optimization should complement medical optimization prior to elective surgery.
- Implant design must account for host biology, especially in cases of poor bone quality or healing capacity.
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