Understanding the relationship between frailty and longevity becomes increasingly important as the world continues to age and life expectancy in most countries continues to increase. The articles contained in this book are the outcome of a colloquium sponsored by Fondation IPSEN in which interdisciplinary perspectives were brought to bear on conceptual, empirical and clinical aspects of this relationship. The result is a unique, innovative and timely blend of papers on topics ranging from frailty concepts in animal models and early Homo sapiens, to documentation of progress in morbidity compression, on the relationships between frailty and impairments and inflammation, and perspectives on long-term health care needs in an aging world.

The concept of frailty offers a convenient way to introduce unobserved heterogeneity and associations into models for survival data. In its simplest form, frailty is an unobserved random proportionality factor that modifies the hazard function of an individual or a group of related individuals. Frailty Models in Survival Analysis presents a comprehensive overview of the fundamental approaches in the area of frailty models. The book extensively explores how univariate frailty models can represent unobserved heterogeneity. It also emphasizes correlated frailty models as extensions of univariate and shared frailty models. The author analyzes similarities and differences between frailty and copula models; discusses problems related to frailty models, such as tests for homogeneity; and describes parametric and semiparametric models using both frequentist and Bayesian approaches. He also shows how to apply the models to real data using the statistical packages of R, SAS, and Stata. The appendix provides the technical mathematical results used throughout. Written in nontechnical terms accessible to nonspecialists, this book explains the basic ideas in frailty modeling and statistical techniques, with a focus on real-world data application and interpretation of the results. By applying several models to the same data, it allows for the comparison of their advantages and limitations under varying model assumptions. The book also employs simulations to analyze the finite sample size performance of the models.

Readers will find in the pages of this book a treatment of the statistical analysis of clustered survival data. Such data are encountered in many scientific disciplines including human and veterinary medicine, biology, epidemiology, public health and demography. A typical example is the time to death in cancer patients, with patients clustered in hospitals. Frailty models provide a powerful tool to analyze clustered survival data. In this book different methods based on the frailty model are described and it is demonstrated how they can be used to analyze clustered survival data. All programs used for these examples are available on the Springer website.

Frailty represents an important challenge for aging populations. As a concept it is full of 'known unknowns' such as which mechanisms lead to frailty and how it is best managed. In order to examine these circumstances, the new science of understanding and managing frailty requires an appropriate framing of the problem. This publication investigates the biology and management of frailty and its social aspects. It considers these and related questions: How can we recognize frailty? How does an understanding of frailty increase our comprehension of the aging process? What are its implications for health care systems, including primary care, hospitals and rehabilitation? How will a growing number of frail older adults affect society more generally? The book focuses on frailty as a state of vulnerability, which is related to aging, but which can occur across the life course, and aims to improve the life of frail people and those around them. The book is highly recommended to researchers in aging, health science researchers, health care professionals and anyone interested in the understanding of the aging process.

This book aims to clarify the potential association between frailty and cardiovascular disease in older people. Covering the biological as well as the clinical point of view, it allows researchers and clinicians to discover the significance of this topic. The contributions cover the most important aspects in the potential relationship between frailty and cardiovascular disease. In particular, authoritative authors in this field have clarified the definition and the epidemiology of frailty and cardiovascular disease in older people. A large part of the volume is dedicated to the biological mechanisms of frailty and cardiovascular disease, trying to find those in common between these two conditions. Since this book is dedicated to both researchers and clinicians, we have proposed some chapters to the importance of comprehensive geriatric assessment in the evaluation and treatment of cardiovascular diseases and frailty. In this regard, the importance of geriatric evaluation in cardiac surgery for older people is well covered. Finally, the importance of cardiac rehabilitation and physical exercise is summarized, being, actually, the most important treatments for both frailty and cardiovascular disease. Written by many well-known and widely published experts in their respective fields, this book will appeal to a wide readership such as researchers in the field and clinicians, especially suited in geriatric medicine and cardiology who, every day, face frail older patients.