Frailty in multiple sclerosis: A closer look at the deficit accumulation framework.

Abstract

The growing availability and effectiveness of diseasemodifying therapies has increased the life expectancy of people living with multiple sclerosis (MS). Consequently, there is an emerging need to explore the impact of age-related conditions on health outcomes in this population. In this regard, the investigation of frailty, a biological syndrome of decreased reserve and resistance to stressors arising from cumulative declines across multiple physiologic systems, may offer valuable insights to improve our understanding of the challenges older people with MS may face, and thus allow us to optimize care and quality of life of people with MS. While many approaches to conceptualize and evaluate frailty exist, the frailty index (FI), based on the deficit accumulation framework,1 has often appealed to clinicians due to its adaptability and utility in routine care.