Frailty Syndrome as a Transition from Compensation to Decompensation: Application to the Biomechanical Regulation of Gait

Lesli Álvarez-Millán, Daniel Castillo-Castillo, Rosa Quispe-Siccha, Argelia Pérez-Pacheco, Maia Angelova, Jesús Rivera-Sánchez and Ruben Fossion ()
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Lesli Álvarez-Millán: Doctorado en Ciencias Biomédicas, Universidad Nacional Autónoma de México (UNAM), Mexico City 04510, Mexico
Daniel Castillo-Castillo: Unidad de Investigación y Desarrollo Tecnológico (UIDT), Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico
Rosa Quispe-Siccha: Unidad de Investigación y Desarrollo Tecnológico (UIDT), Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico
Argelia Pérez-Pacheco: Unidad de Investigación y Desarrollo Tecnológico (UIDT), Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico
Maia Angelova: School of Information Technology, Melbourne Burwood Campus, Deakin University, Burwood, VIC 3125, Australia
Jesús Rivera-Sánchez: Servicio de Geriatría, Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico
Ruben Fossion: Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México (UNAM), Mexico City 04510, Mexico

IJERPH, 2023, vol. 20, issue 11, 1-18

Abstract: Most gait parameters decrease with age and are even more importantly reduced with frailty. However, other gait parameters exhibit different or even opposite trends for aging and frailty, and the underlying reason is unclear. Literature focuses either on aging, or on frailty, and a comprehensive understanding of how biomechanical gait regulation evolves with aging and with frailty seems to be lacking. We monitored gait dynamics in young adults (19–29 years, n = 27, 59% women), middle-aged adults (30–59 years, n = 16, 62% women), and non-frail (>60 years, n = 15, 33% women) and frail older adults (>60 years, n = 31, 71% women) during a 160 m walking test using the triaxial accelerometer of the Zephyr Bioharness 3.0 device (Zephyr Technology, Annapolis, MD, USA). Frailty was evaluated using the Frail Scale (FS) and the Clinical Frailty Scale (CFS). We found that in non-frail older adults, certain gait parameters, such as cadence, were increased, whereas other parameters, such as step length, were decreased, and gait speed is maintained. Conversely, in frail older adults, all gait parameters, including gait speed, were decreased. Our interpretation is that non-frail older adults compensate for a decreased step length with an increased cadence to maintain a functional gait speed, whereas frail older adults decompensate and consequently walk with a characteristic decreased gait speed. We quantified compensation and decompensation on a continuous scale using ratios of the compensated parameter with respect to the corresponding compensating parameter. Compensation and decompensation are general medical concepts that can be applied and quantified for many, if not all, biomechanical and physiological regulatory mechanisms of the human body. This may allow for a new research strategy to quantify both aging and frailty in a systemic and dynamic way.

Keywords: frailty; gait; homeostasis; dysregulation; decompensation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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