衰弱是一种临床上较为常见的老年综合征，其特征是多个器官系统的生理能力下降，从而增加了对应激事件的敏 感性，在老年外科患者中患病率较高。遗传因素、人口和社会学因素、不良的生活方式、营养不良、肌肉减少症、焦虑和抑郁等 均是衰弱的危险因素，衰弱综合征的发生是多种因素交互影响的结果，包括衰老相关变化、基因和环境、慢性疾病等。衰弱与 营养不良密切相关，两者有许多共同的病理生理途径，包括身体组织的丧失和慢性炎症，且两者的筛查评估工具也有重叠的指 标，如体重丢失和身体功能受损。衰弱与不良临床结局发生相关，可导致老年外科患者发生失能、功能下降，死亡和术后并发 症的风险增加，住院时间延长、住院费用增多，增加了对长期照护的需求和降低生活质量。老年外科衰弱患者的有效干预手段 是运动干预和营养治疗，运动干预应该是渐进性、个性化的，以抗阻运动为核心，辅以有氧运动、平衡和柔韧性训练，如果仅通 过饮食不能满足老年外科患者推荐的能量和蛋白质目标60%以上，则首选口服营养补充以改善营养不良状态。

Frailty is a clinically more common geriatric syndrome characterized by decreased physiological capacity of multiple organ systems, thus increasing sensitivity to stressful events, with a high prevalence in geriatric surgical patients. Genetic factors, demographic and sociological factors, poor lifestyle, malnutrition, sarcopenia, anxiety, and depression are all risk factors for frailty, and the occurrence of frailty syndrome is the result of the interaction of multiple factors, including aging⁃related changes, genes and environment, and chronic diseases. Frailty is closely related to malnutrition, both of which share many pathophysiological pathways, including loss of body tissue and chronic inflammation, and both screening assessment tools also have overlapping indicators, such as weight loss and impaired physical function. Frailty is associated with adverse clinical outcomes, which can lead to disability and reduced function in elderly surgical patients, increased risk of death and postoperative complications, prolonged length of hospital stays, increased hospital costs, increased need for long⁃term care and poor quality of life. The effective intervention means for elderly surgical frail patients are exercise intervention and nutritional support. Exercise intervention should be progressive and personalized, with resistance exercise as the core, supplemented by aerobic exercise, balance and flexibility training. If more than 60% of the recommended energy and protein goals for elderly surgical patients cannot be met through diet alone, oral nutritional supplementation is preferred to improve malnutrition status.