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The FIBRA Network is a multicentric project designed to investigate the features and prevalence of the biological frailty syndrome, according to Fried et al's frailty phenotype, 6 among Brazilian older adults.
Additionally, we suggested further research in the fatigue sub-item in the biological frailty model to see if the fatigue sub-item is driven by physical or psychological components [ 16].
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As understanding on the biological aspects of frailty is furthered, other questions emerge regarding how frailty is related with other social and psychological aspects that can be associated with the aging process.
Frailty researchers like Dr. Jeremy Walston, at Johns Hopkins, and others are investigating the biological markers of frailty to develop treatments and interventions that could help prevent it.
In recent times, research for biological markers of frailty has gained impetus.
Limited evidence exists of plausible biological markers of frailty.
Included studies used an explicit biological definition of frailty based on Fried et al's criteria and a screening measure to identify depressive symptomatology.
Several biological ageing and frailty markers described in experimental geriatrics have been proposed to reflect 'biological age' more accurately than clinical assessment [ 5], but this still needs to be proven.
18, 19 Similarly, studies reporting substantial shared variance between the biological syndromes of frailty and depression 21, 22 appear to have more liberal inclusion criteria (ie, participants with a history of clinical depression), and therefore it is unclear whether dementia and stroke are part of the exclusion criteria as in the Fried et al's 1 study.
Using a confirmatory factor analytic approach in the HRS 21 study in 3,453 participants, the same investigators demonstrated a moderate correlation (0.68) between latent categorical models of depression and the "biological definition" of frailty, but when overlapping symptoms were accounted for this decreased to 0.45.
As GA alone is not sufficient to predict outcome and tolerance to chemotherapy[ 35, 36], there is an increasing interest to integrate it with specific biomarkers that reflect biological ageing and frailty in individuals affected by cancer, in order to get a more complete picture of the patients' physiological reserves and capability to tolerate chemotherapy.
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