Interactions Between 'Giants': The Relationship Between Internal Milieu Disorders and Frailty Syndrome

Geriatrics has classically described four entities of its own, naming them “geriatric giants” because of their high prevalence and great impact on the senile health. These four significant syndromes are delirium, gait disorders and falls, immobility syndrome, and incontinence. Additionally, older people are predisposed to suffer from salt and water alterations since aging induces changes in their renal physiology. These are known as the “nephrogeriatric giants”: reduced glomerular filtration rate, sodium and water reabsorption, and potassium secretion capability. These syndromes, the geriatric giants and the nephrogeriatric giants, usually predispose to one another and potentiate each other, leading to internal milieu disorders and catastrophic clinical events.