Falls, frailty and osteoporosis in the elderly.

Introduction. - Elderly people can be subdivided into three groups: healthy elderly persons (65-70% of the population), elderly subjects with diseases (about 5%) and frail old people. Frailty represents "age-related physiolog ic vulnerability resulting from impaired homeotasic stock and a reduced cap acity of the organism to withstand stress". If could lead elderly subjects to pathological, barely reversible, ageing. Current knowledge and key points. - One of the main objective of geriatrici ans is to develop useful screening tools to identify people at high risk, t hus allowing them to benefit from preventive interventions as early as poss ible. It has been suggested that the decline in homeostatic stock involves numerous physiological systems. Those at the core of frailty would be neuro muscular changes resulting in sarcopenia, neuroendocrine dysregulation, and immune disorders. A recent study has shown that increased levels of interl eukin 6 is a risk factor for frailty. Future prospects and projects. - Work in progress aimed at identification o f at-risk patients should: lead to early detection; draw attention on under estimated fields such as the nutritional status, sarcopenia, or gait disord ers; promote the development of the standardized gerontological evaluation in order to identify the different components of frailty; and promote the d evelopment of non-pharmalogical programmes including physical training, nut ritional managing, and optimal social life. (C) 2000 Editions scientifiques et medicales Elsevier SAS.