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[Biological age in orthopedics : Importance, assessment, and clinical recommendations]
Stefan Dalichau1, Philip Meyer2
1BG Ambulanz Bremen, BG Kliniken - Klinikverbund der gesetzlichen Unfallversicherung, Industriestr. 3, 28199, Bremen, Deutschland. Stefan.dalichau@bga-bremen.de.
Background:
Chronological age insufficiently reflects differences in physiological reserve, resilience, and regenerative capacity. Biological age (BA) estimates aging from molecular, physiological, and functional characteristics.
Objectives:
To describe BA concepts and assessment methods and evaluate their relevance for orthopedic rehabilitation.
Materials And Methods:
Narrative review based on structured MEDLINE/PubMed and manual search, with a focus on reviews, meta-analyses, consensus papers, and key methodological studies.
Results:
Epigenetic, phenotypic, and laboratory-based models capture different dimensions of aging and are not directly comparable. Frailty, sarcopenia, gait speed, chair-rise performance, grip strength, endurance, and deficit accumulation have the greatest practical value. Frailty and sarcopenia predict complications, prolonged care, non-home discharge, and mortality after orthopedic procedures beyond chronological age.
Conclusions:
BA should be interpreted as a multidimensional risk profile. A staged assessment combining frailty screening, muscle strength, mobility, endurance, nutrition, and cognition is recommended. Molecular aging clocks are not currently recommended for routine care.
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