Theprevalence and incidence of frailty is variable, with percentages between 33-88%. The prevalence in Latin America is between 30-48% in women and 21-35% in men. The prevalence in Mexico is 39%, more frequently in women than in men. Fragility is a physiological syndrome characterized by reduced reserves and reduced resistance to stressors as a result of the cumulative decline of multiple physiological systems that increase vulnerability for adverse health outcomes. Some authors distinguish primary frailty as that caused by multiple physiological decline associated only with aging and secondary frailty that is associated with diseases or even disability.
Older adults are vulnerable mainly to chronic diseases, sensory medical alterations such as vision, hearing, malnutrition, polypharmacy, cognitive deterioration, depression, dependence on basic and instrumental activities of daily life, alteration in walking and deficiency in social support; it is frequent that the older adult does not express all his discomforts, due to shame or because of the type of attention in the classic consultation, where the time for medical attention is decreasing; all this makes it difficult to recognize diagnostics. Within the syndrome of frailty one of the risks that exist are falls, which are cause of increase in morbidity and mortality in older adults. The incidence of falls and the severity of complications increases after the age of 60; in developed countries, accidental falls are listed as the fifth cause of death in older adults, after cardiovascular diseases, cancer, stroke and lung disorders.
Amongthe systems involved in the frailty syndrome is the cardiovascular, neuroendocrine, metabolic, immune system and skeletal muscle system. There are two physical changes associated with aging and may be the main cause of frailty: sarcopenia and osteopenia. The loss of muscle mass and power is a universal loss, occurs over the years, even in people who regularly perform moderate physical exercise. The muscle mass decreases by 3-8% per decade from the age of 30. This produces a progressive decrease in strength and contributes to the disability and loss of independence of the elderly. Fragility and sarcopenia overlap, most frail elderly people have sarcopenia and many of the elderly with sarcopenia are fragile.