Clinical Anti-Aging Medicine: Sarcopenia, Frailty, and Anti-Aging Medicine

Amid growing attention to “frailty” that impairs the healthy lifespan of the elderly, the Ministry of Health, Labour and Welfare has decided to tackle the understanding of frailty in the medical check-up of the late-stage elderly medical system for those aged 75 and over, taking the fiscal year 2020, when the number of late-stage elderly surpasses the early-stage elderly for the first time, as an opportunity. “Frailty” is the ultimate medical and nursing concept that captures the multifaceted weakening due to aging, including physical factors, mental and psychological factors, and social factors, without missing signs of aging, supports the independence of the elderly in a multifaceted way, and revitalizes the elderly. Until now, it has been overlooked as an “aging phenomenon,” but by using “frailty” as a unified name, we aimed to reform the awareness of medical care and nursing. In other words, frailty was defined as “a state where physiological reserve capacity decreases in old age, vulnerability to stress increases, and it is easy to fall into outcomes such as functional disability, need for care, death, etc.” Not only life prognosis and disease measures for the elderly, but also dealing with “frailty” with life function as an endpoint through integrated understanding will be a new mission in geriatric medicine. Frailty is accelerated by malnutrition and sarcopenia, but the “Frailty Health Check Sheet” [1] consisting of 10 categories and 15 questions includes malnutrition, but it is not enough with just walking speed and falls for sarcopenia. It is thought that items related to sarcopenia, such as “difficulty in opening the cap of a pet bottle,” which indicates a decrease in grip strength, are also necessary. It might be good to add checks that do not miss signs of aging due to sarcopenia, such as “stand up, walk” and “climb stairs,” which are basic daily activities for the elderly, from the sarcopenia screening method SARC-F/SARC-Calf [2].