Fig. 4. (Online color) The low physical function is both fragile and sarcopineninia (adapted by (reference Cesari, Landi and Vellas 62)). These high estimates of prevalence and costs have led to these conditions being more commonly considered in clinical practice (93). Case research has been proposed in the acute medical environment (94) for the care of elderly adults, which are being considered for aggressive oncology treatments (Handforth, Clegg and Young 95), in uplifting and acute surgery (reference Anaya, Johanning and Spector 96 , Reference Refrigerators, Harari and Dhesi 97) and primary care (93). Primary care indicates that fragility may be important in the treatment of traditional disease risk factors, such as high blood pressure, which may behave differently in frail patients (Reference Muller, Smulders and Leeuw 98, Reference Odden, Peralta and Haan 99). In addition, there is room for early intervention to prevent or delay a disability at the end of life, with frailty and sarcopenia often preceded by a disability, but potentially reversible conditions. On the other hand, a disability is difficult to reverse once it has occurred (reference Fried, Ferrucci and Darer 11). For example, it would be possible to identify older adults who may be in medical services and benefit most from a comprehensive geriatric assessment (CGA). CGA is a multidimensional and interdisciplinary review of an older person`s medical, functional and psychosocial needs to formulate a personalized treatment plan and long-term follow-up. It turned out that the likelihood that seniors living and in their own homes 1 year after an emergency hospitalization (Ellis, Whitehead and Robinson 100) improved, but the available clinical resources are not sufficient to provide CGA to all seniors. As a result, fragile velvets could help promote equity in access to CGA services. However, it is likely that sarcopenia and frailty will be more common in patient populations than in community cohorts.
Given the known associations of sarcopenia and fragility with negative health consequences, it is therefore not surprising that the estimated health costs of these diseases are high. For example, in 2000, $18.5 billion in spending was allocated to health care in the United States (Reference Janssen, Shepard and Katzmarzyk 91). Similarly, one study calculated the absolute cost of surgical procedures in frail patients three times ($76,363 ($48,495) per patient, as non-fragile patients ($27,731 (15,693) per patient (Robinson, Wu and Stiegmann 92). Janssen I, Heymsfield SB, Ross R. Low relative skeletal mass (SarcopeniaI in the elderly is associated with functional and physical disabilities. To Geriat soc. 2002;50:889–96. The current consensus continues to believe that fragility is broader than reduced function and sarcopenia alone (Reference Morley, Vellas and van Kan 9) and it is not clear to what extent sarcopenia and fragility overlap as clinical syndromes (Reference Cesari, Landi and Vellas 62). However, there is a general consensus that reduced physical function is a common feature of both conditions and there are a number of simple and validated measures of physical function that could be used in the clinical environment to identify people at risk of these conditions (Reference Cesari, Landi and Vellas 62). dos Reis AS, Santos HO, Limirio LS, de Oliveira EP.