Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-23T16:24:19.027Z Has data issue: false hasContentIssue false

Chapter 33 - Morbid Obesity and Frailty

Problems with the Extremes of Weight in Elders

Published online by Cambridge University Press:  11 July 2020

By
Roger W. Byard
Edited by
Kim A. Collins  and
Roger W. Byard
Kim A. Collins
Affiliation:
LifePoint Inc, South Carolina
Roger W. Byard
Affiliation:
University of Adelaide
Get access

Summary

Obesity and frailty have been variably defined; however one of the most useful measures is the body mass index (BMI), which is the weight of an individual in kilograms divided by the height in meters squared. BMI units are kg/m2; the normal range lies between 18.5 and 24.9 kg/m2, with underweight individuals falling below 18.5 kg/m2 and overweight or obese above 30. Usually, the units for BMI are left off the value.

Type
Chapter
Information
Geriatric Forensic Medicine and Pathology , pp. 589 - 606
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Byard, R.W., Bellis, M.. Significant increases in body mass index (BMI) in an adult forensic autopsy population from 1986 to 2006 – implications for modern forensic practice J Forensic Legal Med 2008; 15: 356–8.Google Scholar
Zalesin, K.C., Franklin, B.A., Miller, W.M., Peterson, E.D., McCullough, P.A.. Impact of obesity on cardiovascular disease. Med Clin North Am 2011; 95: 919–37.Google Scholar
Zamboni, M., Mazzali, G., Zoico, E., et al. Health consequences of obesity in the elderly: a review of four unresolved questions. Int J Obes 2005; 29: 1011–29.Google Scholar
Batsis, J.A., Zagaria, A.B.. Addressing obesity in aging patients. Med Clin North Am 2018; 102: 65–85.Google Scholar
Waters, D.L., Ward, A.L., Villareal, D.T.. Weight loss in obese adults 65 years and older: a review of the controversy. Exp Gerontol 2013; 48: 1054–61.Google Scholar
Byard, R.W.. Frailty syndrome – medicolegal considerations. J Forensic Leg Med 2015; 30C: 34–8.Google Scholar
Byard, R.W.. Forensic issues at the extremes of weight: from frailty syndrome through frail obesity to morbid obesity. J Forensic Leg Med 2015; 35: 38–9.CrossRefGoogle ScholarPubMed
Amarya, S., Singh, K., Sabharwal, M.. Health consequences of obesity in the elderly. J Clin Gerontol Geriatr 2014; 5: 63–7.Google Scholar
Caballero, B.. The global epidemic of obesity: an overview. Epidemiol Rev 2007; 29: 1–5.Google Scholar
Lee, Y.S., So, J.B.Y., Deurenberg-Yap, M.. Confronting the obesity epidemic: call to arms. Ann Acad Med Sing 2009; 38: 1–2.CrossRefGoogle ScholarPubMed
Behn, A., Ur, E.. The obesity epidemic and its cardiovascular consequences. Curr Opin Cardiol 2006; 21: 353–60.Google Scholar
Hunsaker, D.M., Hunsaker, J.C. III. Obesity epidemic in the United States: a cause of morbidity and premature death. In: Forensic Pathology Reviews, Vol 2. Ed. Tsokos, M., Totowa, NJ; Humana Press Inc. 2004; pp. 59–98.Google Scholar
Finucane, M.M., Stevens, G.A., Cowan, M.J., et al. National, regional, and global trends in body-mass indexes a systematic analysis of health examination surveys and epidemiological studies in 960 country-years and 9.1 million participants. Lancet 2011; 377: 557–67.Google Scholar
Shelton, R.C., Miuller, A.H.. Eating ourselves to death (and despair): the contribution of adiposity and inflammation to depression. Prog Neurobiol 2010; 91: 275–99.CrossRefGoogle ScholarPubMed
Oreopoulos, A., Padwal, R., Kalantar-Zadeh, K., et al. Body mass index and mortality in heart failure: a meta-analysis. Am Heart J 2008; 156: 13–22.Google Scholar
Heiat, A., Vaccarino, V., Krumholz, H.M.. An evidence-based assessment of federal guidelines for overweight and obesity as they apply to elderly persons. Arch Int Med 2001; 161: 1194–203.Google Scholar
Calle, E.E., Thun, M.J., Petrelli, J.M., Rodriguez, C., Heath, C.W.. Body-mass index and mortality in a prospective cohort of U.S. adults. New Engl J Med 1999; 341: 1097–105.Google Scholar
Schunkert, H.. Obesity and target organ damage: the heart. Int J Obes 2002; 26: S15-S20.Google Scholar
Garrison, R.J., Kannel, W.B., Stokes, J., Castelli, W.P.. Incidence and precursors of hypertension in young adults: The Framingham Offspring Study. Prev Med 1987; 16: 235–51.Google Scholar
Reisin, E., Jack, A.V.. Obesity and hypertension: mechanisms, cardio-renal consequences, and therapeutic approaches. Med Clin North Am 2009; 93: 733–51.Google Scholar
Iwao, S., Iwao, N., Muller, D.C., Shimokata, H., Andres, R.. Effect of aging on the relationship between multiple risk factors and waist circumference. J Am Geriatr Soc 2000; 48: 788–94.Google Scholar
Engeli, S., Sharma, A.. Emerging concepts in the pathophysiology and treatment of obesity-associated hypertension. Curr Opin Cardiol 2002; 17: 355–9.Google Scholar
De Koning, L., Merchant, A.T., Pogue, J., Anand, S.S.. Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. Eur Heart J 2007; 28: 850–6.Google Scholar
Poirier, P., Giles, T.D., Bray, G.A., et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. An update of the 1997 American Heart Association Scientific Statement on obesity and heart disease from the Obesity Committee of the Council on Nutrition, Physical Activity and Metabolism. Circulation 2006; 113: 898–918.CrossRefGoogle ScholarPubMed
Drenick, E.J., Fisler, J.S.. Myocardial mass in morbidly obese patients and changes with weight reduction. Obes Surg 1992; 2: 19–27.Google Scholar
Kenchaiah, S., Evans, J.C., Levy, D., et al. Obesity and the risk of heart failure. New Engl J Med 2002; 347: 305–13.Google Scholar
McGavock, J.M., Victor, R.G., Unger, R.H., Szczepaniak, L.S.. Adiposity of the heart, revisited. Ann Int Med 2006; 144: 517–24.Google Scholar
Cushman, M.. Epidemiology and risk factors for venous thrombosis. Semin Hematol 2007; 44: 62–69.Google Scholar
Ay, C., Tengler, T., Vormittag, R., et al. Venous thromboembolism – a manifestation of the metabolic syndrome. Haematologica 2007; 92: 374–80.Google Scholar
Rosenfeld, H., Tsokos, M., Byard, R.W.. The association between body mass index and pulmonary thromboembolism in an autopsy population. J Forensic Sci 2012; 57: 1336–8.Google Scholar
Darvall, K.A.L., Sam, R.C., Silverman, S.H., Bradbury, A.W., Adam, D.J.. Obesity and thrombosis. Eur J Vasc Endovasc Surg 2007; 33: 223–33.Google Scholar
Melenik, J., Livingston, E., Cortina, G., Fishbein, M.C.. Autopsy findings following gastric bypass surgery for morbid obesity. Arch Pathol Lab Med 2002; 126: 1091–5.Google Scholar
Byard, R.W.. Mesenteric venous thrombosis. Forensic Sci Med Pathol 2012; 8: 475–6.Google Scholar
Byard, R.W.. Acute mesenteric ischaemia and unexpected death. J Forensic Leg Med 2012; 19: 185–90.Google Scholar
Wang, T.J., Parise, H., Levy, D., et al. Obesity and new-onset atrial fibrillation. JAMA 2004; 292: 2471–7.CrossRefGoogle ScholarPubMed
Lavie, C.J., Milani, R.V., Ventura, H.O.. Obesity and cardiovascular disease. Risk factors, paradox, and impact of weight loss. J Am Col Cardiol 2009; 53: 1925–32.Google Scholar
Lloyd, G.E.R.. Hippocratic Writings. Harmondsworth, Penguin Books. 1978, p. 212.Google Scholar
Abu Hilal, M., Armstrong, T.. The impact of obesity on the course and outcome of acute pancreatitis. Obes Surg 2008; 18: 326–8.Google Scholar
Austin, M.A., Hokanson, J.E., Edwards, K.L.. Hypertriglyceridemia as a cardiovascular risk factor. Am J Cardiol 1998; 81: 7B-12B.Google Scholar
Pi-Sunyer, F.X.. Medical hazards of obesity. Ann Intern Med 1993; 119: 655–60.Google Scholar
Byard, R.W.. Obesity – pathology. In: Encyclopedia of Forensic and Legal Medicine, 2nd ed. Vol. 2. Eds. Payne-James, J., Byard, R.W., Oxford, Academic Press, 2016, pp. 96–104.CrossRefGoogle Scholar
Byard, R.W.. The complex spectrum of forensic issues arising from obesity. Forensic Sci Med Pathol 2012; 8: 402–13.Google Scholar
Ford, E.S., Giles, W.H., Dietz, W.H.. Prevalence of metabolic syndrome among US adults. Findings from the Third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356–9.Google Scholar
Garcia Hildalgo, L.. Dermatological complications of obesity. Am J Clin Dermatol 2002; 3: 497–506.Google Scholar
Kokkoris, P., Pi-Sunyer, F.X.. Obesity and endocrine disease. Endocrinol Metab Clin North Am 2003; 32: 895–914.Google Scholar
Ahima, R.S., Flier, J.S.. Adipose tissue as an endocrine organ. Trends Endocrinol Metab 2000; 11: 327–32.Google Scholar
Zhou, C., Byard, R.W.. An analysis of the morbidity and mortality of diabetes mellitus in a forensic context. J Forensic Sci 2018.CrossRefGoogle Scholar
Mokdad, A.H., Ford, E.S., Bowman, B.A., et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003; 289: 76–9.Google Scholar
Foxx-Orenstein, A.E.. Gastrointestinal symptoms and disease related to obesity: an overview. Gastroenterol Clin North Am 2010; 39: 23–37.Google Scholar
Caldwell, S.H., Crespo, D.M., Kang, K.S., Al-Osaimi, A.M.S. Obesity and hepatocellular carcinoma. Gastroenterology 2004; 127: S97-S103.Google Scholar
McCallister, J.W., Adkins, E.J., O’Brien, J.M.. Obesity and acute lung injury. Clin Chest Med 2009; 30: 495–508.Google Scholar
Muzumdar, H., Rao, M.. Pulmonary dysfunction and sleep apnea in morbid obesity. Pediatr Endocrinol Rev 2006; 3(Suppl 4): 579–83.Google Scholar
Rabec, C., de Lucas Ramos, P., Veale, D.. Respiratory complications of obesity. Arch Bronco 2011; 472: 52–61.Google Scholar
Redd, S.C.. Asthma in the United States; burden and current theories. Environ Health Perspect 2002; 110: 557–60.Google Scholar
Byard, R.W., Omond, K.J., Langlois, N.E.I.. Is obesity a factor in sudden asthmatic deaths? Aust J Forensic Sci 2012; 57: 1641–2.Google Scholar
Grimm, W., Becker, H.F.. Obesity, sleep apnea syndrome, and rhythmogenic risk. Herz 2006; 31: 213–8.Google Scholar
Grunstein, R., Wilcox, I., Yang, T.S., Gould, Y., Hedner, J.. Snoring and sleep apnoea in men: association with central obesity and hypertension. Int J Obes Relat Metab Disord 1993; 9: 533–40.Google Scholar
Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., Badr, S.. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993; 328: 1230–5.Google Scholar
Kurukulasuriya, L.R., Stas, S., Lastra, G., Manrique, C., Sowers, J.R.. Hypertension in obesity. Med Clin North Am 2011; 95: 903–17.Google Scholar
Chebbo, A., Tfaili, A., Jones, S.F.. Hypoventilation syndromes. Med Clin North Am 2011; 95: 1189–1202.Google Scholar
Serrano, P.E., Khuder, S.A., Fath, J.J. Obesity as a risk factor for nosocomial infections in trauma patients. J Am Coll Surg 2010; 211: 61–7.Google Scholar
Zhou, C., Byard, R.W.. Factors and processes causing accelerated decomposition in human cadavers. J Forensic Leg Med 2011; 18: 6–9.Google Scholar
Bury, D., Byard, R.W.. Fournier gangrene and unexpected death. J Forensic Sci 2012; 57: 1641–2.Google Scholar
Fezeu, L., Julia, C., Henegar, A. A, et al. Obesity is associated with higher risk of intensive care unit admission and death in influenza A (H1N1) patients: a systematic review and meta-analysis. Obes Rev 2011; 12: 653–9.CrossRefGoogle ScholarPubMed
Falagas, M.E., Kompoti, M.. Obesity and infection. Lancet Infect Dis 2006; 6: 438–46.Google Scholar
Wolin, K.Y., Carson, K., Colditz, G.A.. Obesity and cancer. The Oncologist 2010; 15: 556–65.Google Scholar
Calle, E.E., Rodriguez, C., Walker-Thurmond, K., Thun, M.J.. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 2003; 348: 1625–38.Google Scholar
Bergström, A., Pisani, P., Tenet, V., Wolk, A., Adami, H.-O.. Overweight as an avoidable cause of cancer in Europe. Int J Cancer 2001; 91: 421–30.Google Scholar
Hemminki, K., Li, X., Sundquist, J., Sundquist, K.. Obesity and familial obesity and risk of cancer. Eur J Cancer Prev 2011; 20: 438–43.Google Scholar
Petrilli, J.M., Calle, E.E., Rodriguez, C., Thun, M.J.. Body mass index, height, and postmenopausal breast cancer mortality in a prospective cohort of US women. Cancer Causes Control 2002; 13: 325–32.Google Scholar
Hill, H.A, Austin, H.. Nutrition and endometrial cancer. Cancer Causes Control 1996; 7: 19–32.Google Scholar
Lagergren, J., Bergström, R., Nyrén, O.. Association between body mass and adenocarcinoma of the esophagus and gastric cardia. Ann Int Med 1999; 130: 883–90.Google Scholar
Crew, K.D., Neugut, A.I.. Epidemiology of gastric cancer. World J Gastroenterol 2006; 12: 354–62.Google Scholar
Moghaddam, A.A., Woodward, M., Huxley, R.. Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70,000 events. Cancer Epidemiol Biomarkers Prev 2007; 16: 2533–47.Google Scholar
Buschemeyer, W.C III, Freedland, S.J.. Obesity and prostate cancer: epidemiology and clinical implications. Eur J Urol 2007; 52: 331–43.Google Scholar
Kristal, A.R., Gong, Z.. Obesity and prostate cancer mortality. Future Oncol 2007; 3: 557–67.Google Scholar
Tanner, B.D., Allen, J.W.. Complications of bariatric surgery: implications for the covering physician. Am Surg 2009; 75: 103–12.Google Scholar
Abell, T.L., Minocha, A.. Gastrointestinal complications of bariatric surgery: diagnosis and therapy. Am J Med Sci 2006; 331: 214–8.Google Scholar
Podnos, Y.D., Jimenez, J.C., Wilson, S.E., Stevens, C.M., Ngyen, N.T.. Complications after laparoscopic gastric bypass. Arch Surg 2003; 138: 957–61.Google Scholar
Gagner, M., Milone, L., Yung, E., Broseus, A., Gumbs, A.A.. Causes of early mortality after laparoscopic adjustable gastric banding. J Am Coll Surg 2008; 206: 664–9.Google Scholar
Gagner, M., Milone, L., Trelles, N.. Mortality after laparoscopic adjustable gastric banding: results from an anonymous questionnaire to ASBS members. Obes Surg 2009; 19: 1657–63.Google Scholar
Lehnhardt, M., Homann, H.H., Daigeler, A., et al. Major and lethal complications of liposuction: a review of 72 cases in Germany between 1990 and 2002. Plast Reconstr Surg 2008; 121: 396e-403e.Google Scholar
Barillo, D.J., Cancio, L.C., Seung, H.K., Shirani, K.Z., Goodwin, C.W.. Fatal and near-fatal complications of liposuction. South Med J 1998; 91: 487–92.CrossRefGoogle ScholarPubMed
Wang, H-D., Zheng, J-H., Deng, C-L., Liu, Q-Y., Yang, S-L.. Fat embolism syndromes following liposuction. Aesth Plast Surg 2008; 32: 731–6.Google Scholar
Pannell, M., Byard, R.W.. Sigmoid volvulus and unexpected death in the elderly. J Clin Forensic Med 2001; 8: 228–230.Google Scholar
Tseuda, K., Debrand, M., Bivins, B.A., Wright, B.D., Griffen, W.O.. Pulmonary complications in the morbidly obese following jejunoileal bypass surgery under narcotic anesthesia. Int Surg 1980; 65: 123–9.Google Scholar
Abbott, K.C., Oliver, D.K., Hurst, F.P., et al. Body mass index and peritoneal dialysis: “exceptions to the exception” in reverse epidemiology? Semin Dialy 2007; 20: 561–5.Google ScholarPubMed
Juvin, P., Lavaut, E., Dupont, H. H, et al. Difficult tracheal intubation is more common in obese than in lean patients. Anesth Analg 2003; 97: 595–600.Google Scholar
Zizza, C., Herring, A.H., Stevens, J., Popkin, B.M.. Length of hospital stays among obese patients. Am J Public Health 2004; 94: 1587–91.Google Scholar
Mock, C.N., Grossman, D.C., Kaufman, R.P., Mack, C.D., Rivara, F.P.. The relationship between body weight and risk of death and serious injury in motor vehicle crashes. Accid Anal Prev 2002; 34: 221–8.CrossRefGoogle ScholarPubMed
Boulanger, B.R., Milzman, D., Mitchell, K., Rodriguez, A.. Body habitus as a predictor of injury pattern after blunt trauma. J Trauma 1992; 33: 228–32.Google Scholar
Spaine, L.A., Bollen, S.R.. ‘The bigger they come … ’: the relationship between body mass index and severity of ankle fractures. Injury 1996; 27: 687–9.Google Scholar
Austin, A.E., van den Heuval, C., Byard, R.W.. BMI and suicide. Am J Forensic Med Pathol 2014; 35: 145–7.Google ScholarPubMed
Omond, K.J., Langlois, N.E.I., Byard, R.W.. Obesity, body mass index and homicide. J Forensic Sci 2017; 62: 930–3.Google Scholar
Byard, R.W.. Increasing body mass and the mortuary. Forensic Sci Med Pathol 2010; 6: 247–8.CrossRefGoogle ScholarPubMed
Byard, R.W., Farrell, E.R., Simpson, E.. Diagnostic yield and characteristic features in a series of decomposed bodies subject to coronial autopsy. Forensic Sci Med Pathol 2008; 4: 9–14.Google Scholar
Ahmed, N., Mandel, R., Fain, M.J.. Frailty: an emerging geriatric syndrome. Am J Med 2007; 120: 748–53.CrossRefGoogle ScholarPubMed
Sternberg, S.A., Schwartz, A.W., Karunananthan, S., Bergman, H., Clarfield, A.M.. The identification of frailty: a systematic literature review. J Am Geriatr Soc 2011; 59: 2129–38.Google Scholar
Topinková, E.. Aging, disability and frailty. Ann Nutrit Metab 2008; 52(Suppl 1): 6–11.Google Scholar
Gielen, E., Verschueren, S., O’Neill, T.W., et al. Musculoskeletal frailty: a geriatric syndrome at the core of fracture occurrence in older age. Calc Tissue Int 2012; 91: 161–77.Google Scholar
Heuberger, R.A.. The frailty syndrome: a comprehensive review. J Nutr Gerontol Geriatr 2011; 30: 315–68.Google Scholar
Lang, P-O., Michel, J-P., Zekry, D.. Frailty syndrome: a transitional state in a dynamic process. Gerontology 2009; 55: 539–49.Google Scholar
Evans, W.J., Paolisso, G., Abbatecola, A.M., et al. Frailty and muscle metabolism dysregulation in the elderly. Biogerontology 2010; 11: 527–36.CrossRefGoogle ScholarPubMed
Rockwood, K., Stadnyk, K., MacKnight, C., I. et al. A brief clinical instrument to classify frailty in elderly people. Lancet 1999; 353: 205–6.Google Scholar
Fernández-Garrido, J., Ruiz-Ros, V., Buigues, C., Navarro-Martinez, R., Cauli, O.. Clinical features of prefrail older individuals and emerging peripheral biomarkers: a systematic review. Arch Gerontol Geriatr 2014; 59: 7–17.Google Scholar
Fulop, T., Larbi, A., Witkowski, J.M., et al. Aging, frailty and age-related diseases. Biogerontology 2010; 11: 547–63.Google Scholar
Sternberg, S.A., Wershof Schwartz, A., Karunananthan, S., Bergman, H., Clarfield, A.M.. The identification of frailty: a systematic literature review. J Am Geriatr Soc 2011; 59: 2129–38.Google Scholar
Chen, X., Mao, G., Leng, S.X.. Frailty syndrome: an overview. Clin Interv Aging 2014; 9: 433–41.Google Scholar
Strawbridge, W.J., Shema, S.J., Balfour, J.L., Higby, H.R., Kaplan, G.A.. Antecedents of frailty over three decades in an older cohort. J Gerontol B Psychol Sci Soc Sci 1998; 53: S9-16.Google Scholar
Ruiz, M., Cefalu, C., Reske, T.. Frailty syndrome in geriatric medicine. Am J Med Sci 2012; 344: 395–8.Google Scholar
Vanitallie, T.B.. Frailty in the elderly: contributions of sarcopenia and visceral protein depletion. Metabolism 2003; 52(Suppl 2): 22–6.Google Scholar
Shamliyan, T., Talley, K.M.C., Ramakrishnan, R., Kane, R.L.. Association of frailty with survival: a systematic literature review. Ageing Res Rev 2013; 12: 719–36.Google Scholar
Xue, Q-L., Bandeen-Roche, K., Varadhan, R., Zhou, J., Fried, L.P.. Initial manifestations of frailty criteria and the development of frailty phenotype in the women’s health and aging study II. J Gerontol 2008; 63A: 984–90.Google Scholar
Landi, F., Russo, A., Liperoti, R. R, et al.Anorexia, physical function, and incident disability among the frail elderly population: results from the ilSIRENTE study. J Am Med Dir Assoc 2010; 11: 268–74.Google Scholar
Gill, T.M., Gahbauer, E.A., Allore, H.G., Han, L.. Transitions between frailty states among community-living older persons. Arch Intern Med 2006; 166: 418–23.CrossRefGoogle ScholarPubMed
Li, H., Manwani, B., Leng, S.X.. Frailty, inflammation, and immunity. Aging Dis 2011; 2: 466–73.Google Scholar
Mohler, M.J., Fain, M.J., Wertheimer, A.M., Najafi, B., Nikolich-Žugich, J.. The frailty syndrome: clinical measurements and basic underpinnings in humans and animals. Exp Gerontol 2014; 54: 6–13.Google Scholar
Morley, J.E.. Anorexia, sarcopenia, and aging. Nutrition 2001; 17: 660–3.Google Scholar
Morley, J.E., Farr, S.A.. Cachexia and neuropeptide Y. Nutrition 2008; 24: 815–9.Google Scholar
Krasnow, S.M., Marks, D.L.. Neuropeptides in the pathophysiology and treatment of cachexia. Curr Opin Support Palliat Care 2010; 4: 266–71.Google Scholar
Wong, C.H., Weiss, D., Sourial, N., et al. Frailty and its association with disability and comorbidity in a community-dwelling sample of seniors in Montreal: a cross-sectional study. Aging Clin Exp Res 2010; 22: 54–62.Google Scholar
Janssen, H.C.J.P., Samson, M.M., Meeuwsen, I.B.A.E., Duursma, S.A., Verhaar, H.J.J.. Strength, mobility and falling in women referred to a geriatric outpatient clinic. Aging Clin Exp Res 2004; 16: 122–5.CrossRefGoogle ScholarPubMed
Frisoli, A., Chaves, P.H., Ingham, S.J., Fried, L.P.. Severe osteopenia and osteoporosis, sarcopenia, and frailty status in community-dwelling older women: results from the Women’s Health and Aging Study (WHAS) II. Bone 2011; 48: 952–7.Google Scholar
Jang, S-N., Chung, H-U., Kwon, I-S., Park, S.C., Cho, S-I.. Functional status and calcaneal quantitative ultrasound measurements among the oldest old people living in rural areas of Korea. Arch Gerontol Geriatr 2009; 48: 89–94.Google Scholar
Visschedijk, J., Achterberg, W., van Balen, R., Hertogh, C.. Fear of falling after hip fracture: a systematic review of measurement instruments, prevalence, interventions, and related factors. J Am Geriatr Soc 2010; 58: 1739–48.Google Scholar
Rolland, Y., Abellan van Kan, G., Bénétos, A., et al. Frailty, osteoporosis and hip fracture: causes, consequences and therapeutic perspectives. J Nutr Health Aging 2008; 12: 319–30.Google Scholar
Abbatecola, A.M., Olivieri, F., Corsonello, A., et al. Frailty and safety: the example of diabetes. Drug Saf 2012; 35(Suppl 1): 63–71.Google Scholar
Zhou, C., Yool, A., Byard, R.W.. Renal cortical pallor – a useful macroscopic marker for metabolic derangements at autopsy. J Forensic Sci 2013; 58: 693–6.CrossRefGoogle ScholarPubMed
Weiss, C.O.. Frailty and chronic diseases in older adults. Clin Geriatr Med 2011; 27: 39–52.Google Scholar
Uchmanowicz, I., Łoboz-Rudnicka, M., Szeląg, P., Jankowska-Polańska, B., Łoboz-Grudzień, K.. Frailty in heart failure. Curr Heart Fail Rep 2014; 11: 266–73.Google Scholar
Afilalo, J., Karunananthan, S., Eisenberg, M.J., Alexander, K.P., Bergman, H.. Role of frailty in patients with cardiovascular disease. Am J Cardiol 2009; 103: 1616–21.Google Scholar
Afilalo, J., Alexander, K.P., Mack, M.J., et al. Frailty assessment in the cardiovascular care of older adults. J Am Coll Cardiol 2014; 63: 747–62.Google Scholar
Anstey, K.J., von Sanden, C., Sargent-Cox, K., Luszcz, M.A.. Prevalence and risk factors for depression in a longitudinal, population-based study including individuals in the community and residential care. Am J Geriatr Psychiatry 2007; 15: 497–505.Google Scholar
Bilotta, C., Casè, A., Nicolini, P., et al. Social vulnerability, mental health and correlates of frailty in older outpatients living alone in the community in Italy. Aging Ment Health 2010; 14: 1024–36.Google Scholar
Buigues, C., Padilla-Sánchez, C., Garrido, J.F., et al. The relationship between depression and frailty syndrome: a systematic review. Aging Ment Health 2015; 19: 762–72.Google Scholar
Collard, R.M., Comijs, H.C., Naarding, P., Oude Voshaar, R.C.. Physical frailty: vulnerability of patients suffering from late-life depression. Aging Ment Health 2014; 18: 570–8.Google Scholar
Byard, R.W., Hanson, K., James, R.A., Gilbert, J.D.. Suicide methods in the elderly in South Australia 1981–2000. J Clin Forensic Med 2004; 11: 71–4.Google Scholar
Aguilera, A., Pi-Figuews, M., Arellano, M. M, et al. Previous cognitive impairment and failure to thrive syndrome in patients who died in a geriatric convalescence hospitalization unit. Arch Gerontol Geriatr 2004; Suppl 9: 7–11.Google Scholar
Ávila-Funes, J.A., Amieva, H., Barberger-Gateau, P., et al. Cognitive impairment improves the predictive validity of the phenotype of frailty for adverse health outcomes: the three-city study. J Am Geriatr Soc 2009; 57: 453–61.Google Scholar
Kulmala, J., Nykänen, I., Mänty, M., Hartikainen, S.. Association between frailty and dementia: a population-based study. Gerontology 2014; 60: 16–21.Google Scholar
Kim, J.C., Kalantar-Zadeh, K., Kopple, J.D.. Frailty and protein-energy wasting in elderly patients with end stage kidney disease. J Am Soc Nephrol 2013; 24: 337–51.Google Scholar
Flood, K.L., Carroll, M.B., Le, C.V., et al. Geriatric syndromes in elderly patients admitted to an oncology-acute care for elders unit. J Clin Oncol 2006; 24: 2298–303.Google Scholar
Puts, M.T.E., Monette, J., Girre, V., et al. Does frailty predict hospitalization, emergency department visits, and visits to the general practitioner in older newly-diagnosed cancer patients? Results of a prospective pilot study. Crit Rev Oncol Hematol 2010; 76: 142–51.Google Scholar
Retornaz, F., Monette, J., Batist, G., et al. Usefulness of frailty markers in the assessment of the health and functional status of older cancer patients referred for chemotherapy: a pilot study. J Gerontol A Biol Sci Med Sci 2008; 63A: 518–22.Google Scholar
Wang, G.C., Casolaro, V.. Immunologic changes in frail older adults. Transl Med UniSa 2014; 9: 1–6.Google Scholar
Byard, R.W.. Diogenes or Havisham syndrome and the mortuary. Forensic Sci Med Pathol 2014; 10: 1–2.Google Scholar
Byard, R.W., Tsokos, M.. Forensic issues in cases of Diogenes syndrome. Am J Forensic Med Pathol 2007; 28: 177–81.Google Scholar
Bright, F., Winskog, C., Gilbert, J.D., Byard, R.W.. Additional risk factors for lethal hypothermia. J Forensic Leg Med 2013; 20: 595–7.Google Scholar
Johannesen, M., LoGiudice, D.. Elder abuse: a systematic review of risk factors in community-dwelling elders. Age Ageing 2013; 42: 292–8.Google Scholar
Juby, A.G., Davis, P.. Utility of published guidelines on the use of nonsteroidal anti-inflammatory drugs in the elderly. Clin Rheumatol 2008; 27: 1191–4.Google Scholar
Byard, R.W.. The potential forensic significance of traditional herbal medicines. J Forensic Sci 2010; 55: 89–92.Google Scholar
Farrell, B., Szeto, W., Shamji, S.. Drug-related problems in the frail elderly. Can Fam Physician 2011; 57: 168–9.Google Scholar
Byard, R.W., Butzbach, D.M.. Issues in the interpretation of postmortem toxicology. Forensic Sci Med Pathol 2012; 8: 205–7.Google Scholar
Partridge, J.S., Harari, D., Dhesi, J.K.. Frailty in the older surgical patient: a review. Age Ageing 2012; 41: 142–7.CrossRefGoogle ScholarPubMed
Ganapathi, A.M., Englum, B.R., Hanna, J.M., et al. Frailty and risk in proximal aortic surgery. J Thorac Cardiovasc Surg 2014; 147: 186–91CrossRefGoogle ScholarPubMed
Courtney-Brooks, M., Tellawi, A.R., Scalici, J., et al. Frailty: an outcome predictor for elderly gynecologic oncology patients. Gynecol Oncol 2012; 126: 20–4.Google Scholar
Byard, R.W., Bright, F., Winskog, C.. Reduced body mass index and lethal hypothermia. Aust J Forensic Sci 2014; 46: 451–4.Google Scholar
Porter Starr, K.N, McDonald, S.R., Bales, C.W.. Obesity and physical frailty in older adults: a scoping review of lifestyle intervention trials. J Am Med Dir Assoc 2014; 15: 240–50.Google Scholar
Lu, C-W., Yang, K-C., Chang, H-H., et al. Sarcopenic obesity is closely associated with metabolic syndrome. Obes Res Clin Pract 2013; 7: e301–7.Google Scholar
Dominguez, L.J., Barbagallo, M.. The cardiometabolic syndrome and sarcopenic obesity in older persons. J Cardiometab Syndr 2007; 2: 183–9.Google Scholar
Byard, R.W., Bellis, M.. Incidence of low body mass index in the elderly in forensic cases – a possible marker for frailty syndrome? J Forensic Sci 2016; 61: 676–8.Google Scholar
Zamboni, M., Mazzali, G., Fantin, F., Rossi, A., Di Francesco, V.. Sarcopenic obesity: a new category of obesity in the elderly. Nutr Metab Cardiovasc Dis 2008; 18: 388–95.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×