1. Lewis, Carole B. PhD, PT, GCS, MSG, MPA, Editor

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She looked small. Not like I remembered. "How are you doing?" I asked. "You seem different since the last time I saw you."


She conjured almost every muscle in her body to lift her head to look at me straight in the eyes. "I am getting so weak," she said. "I have lost weight and everything I try to do is such an effort. The worst part of all this is that no one can explain why. Why am I suddenly like this."


We chatted for a while and I began my assessment. She had impairments in areas ranging from nutrition to motion. Where does one start and how does one explain this adequately to the victim of these limitations.


There is a term used in medicine called frailty. You are experiencing it. For numerous reasons your body is not thriving. In your case as with other people with your condition it usually is not explained by a single cause but by a complex combination. We need to investigate each area in which you are not up to par for your age and try to find a reason as well as some means to improve these areas. It will take time. This type of problem will not get better with a single treatment, and it will require some type of effort on your part. The effort required may be in the form of lifestyle changes in terms of exercise or eating for example. Are you willing to try? I promise to go slowly and not push you too hard with testing or treatment. If you need a break you need to tell me. Are you in? Great! Let' s get started."


The above scenario is a common occurrence in the realm of geriatrics. One of my favorite anonymous quotes is "The eye cannot see what the mind does not know." Even though we see frailty on a daily or at least weekly basis we may not see all the causes and options for care.


This outstanding issue of TGR provides excellent insights and information to open our eyes to recent definitions of frailty. It also addresses methods of evaluation and treatment options for this population.


I thank Emi Storey for creating such a brilliant compendium. I highly recommend this as a supplemental test for all courses in geriatrics. It provides current yet creative information on a topic that is extremely important yet poorly explained. This devastating problem will be growing rapidly, and unless works such as this are pursued this important segment of our population will suffer. Thanks to all the authors for doing such a wonderful job. We will all benefit from your efforts.