Specific pairs of diseases can increase synergistically the risk of disability. (synergistic 協(xié)同的)
特殊的成對疾病可以協(xié)同增加病殘的風險。
Arthritis and heart disease coexist in 18% of older adults; although the odds of developing disability are increased by three-fold to four-fold with either disease alone, the risk of disability increases 14-fold if both are present. (arthritis 關節(jié)炎)
有18%的老年人同時患有關節(jié)炎和心臟病，雖然每個疾病可以增加3~4倍的病殘率，但兩個疾病同時存在，可使病殘率提高14倍。
A second way in which older adults differ from younger adults is the greater likelihood that their diseases present with nonspecific symptoms and signs. (likelihood 可能性)
老年與青中年的第二個差異是更容易出現非典型的癥狀和體癥。
Pneumonia and stroke may present with nonspecific changes in mentation as the primary symptom. 肺炎和中風時可出現非典型意識變化作為主要的癥狀。
(pneumonia 肺炎 mentation 精神作用、心理活動 primary 初始的、首要的、主要的)
Similarly, the frequency of silent myocardial infarction increases with increasing age, as does the proportion of patients who present with a change in mental status, dizziness, or weakness rather than typical chest pain. (silent 沉默的、靜止的 proportion 成比例的、相稱的)
同樣地，隱匿性心肌梗塞發(fā)生頻度隨著年齡的增大而增加，這些病人相應地頻發(fā)精神狀態(tài)改變、眩暈、虛弱而不是典型的胸痛癥狀。
As a result, the diagnostic evaluation of geriatric patients must consider a wider spectrum of diseases than generally would be considered in middle-aged adults. (spectrum 譜、光譜)
因此，老年病人的診斷應考慮更廣泛的疾病譜，要超過通常對中年病人所考慮的范圍。
A third condition that is found primarily in older adults is frailty, frailty is thought to be a wasting syndrome that presents with multiple symptoms and signs, including reduced muscle mass, weight loss, weakness, poor exercise tolerance, slowed motor performance, and low physical activity.
(primarily 起初、首先 frailty 脆弱、意志薄弱tolerance 寬容、忍耐、耐受)
主要出現在老年人的第三個情況是衰弱，衰弱被認為屬于衰竭綜合癥，它有許多癥狀和體征中，包括肌肉萎縮、體重下降、虛弱、運動耐受差、動作慢、身體活動少。
Some estimates indicate that the full syndrome is found in 7% of community-dwelling people age 65 and older, and in 25%of community-dwelling people age 85 and older.
(estimate 估計、評價、看法 indicate 指出、表時、象征、適應征)
一些人估計7%的65歲以上社區(qū)老人和25%的85歲以上社區(qū)老人上述癥狀全部出現。
Many institutionalized older adults also are frail. 許多老人院里的老人也是衰弱的。
(institutionalized 使成公共團體、將…收容 frail 身體虛弱的、易損壞的、意志薄弱的)
Frailty is a state of decreased reserve and increased vulnerability to all kinds of stress, from acute infection or injury to hospitalization, and may identify individuals who cannot tolerate invasive therapies. (reserve 保存、克制 vulnerability 易受傷、易受責難)
衰弱是對各種壓力耐受下降、損害增加的一種狀態(tài)，從急性感染、損傷到住院治療，都可以發(fā)現一些人不能忍受侵入性診療措施。
The syndrome of frailty is associated with high risk of falls, needs for hospitalization, disability, and mortality. (fall 跌倒、下降)
衰弱的癥狀與易于病倒、需要住院治療、病殘、死亡的高風險是相關的。
There is early evidence that a core component of frailty is sarcopenia, or loss of muscle mass associated with aging, which occurs in 13 to 24% of persons age 65 to 70 and in 60% of persons age 80 and older.
component 成分、構成要素 sarcopenia 肌減少（癥)、與年齡相關的骨骼肌質量下降
衰弱一個主要成分的早期表現是肌肉減少，或說隨年齡增長的肌肉減少，它發(fā)生在13~24%的65~70歲的老人，60%的80歲以上的老人。
It is likely that dysregulation of multiple physiologic systems, including inflammation, hormonal status, and glucose metabolism, underlies the syndrome, with resulting decreased ability to maintain homeostasis in the face of stress.
dysregulation 失調 homeostasis 內環(huán)境穩(wěn)定
多種生理系統(tǒng)易于失調 ，包括炎癥、激素狀態(tài)、糖的代謝，結果是在壓力面前保持內環(huán)境的穩(wěn)定的能力下降。
Subclinical disease (e.g., atherosclerosis), end-stage chronic disease (e.g., heart failure), or a combination of comorbid diseases may precipitate the syndrome.
atherosclerosis 動脈粥樣硬化
亞臨床疾病(如動脈粥樣硬化), 晚期慢性疾病(如心力衰竭)，或多種疾病并存可共同形成癥狀。
Evidence from randomized, controlled trials shows that resistance exercise, with or without nutritional supplements, and home-based physical therapy can increase lean body mass and strength in even the frailest older adults.
隨機對照試驗的跡象顯示無論有無營養(yǎng)支持和家庭身體療法，即使是最虛弱的老年人，對抗運動能夠增加瘦弱軀體的質量和力量。
This evidence suggests that earlier stages of frailty may be remediable, although end-stage frailty likely presages death. (remediable 可挽回的 presage 預兆、預示)
這個結果提示早期衰弱是可挽回的，盡管末期衰弱常提示死亡。
Fourth, cognitive impairment increases in prominence as people age.
(prominence 突出、顯著 )第四，人們變老時認知損害顯著增加。
Cognitive impairment is a risk factor for a wide range of adverse outcomes, including falls, immobilization, dependency, institutionalization, and mortality.
immobilization 活動能力減少 institutionalization 制度化、專門照料
認知損害是大量不利結果的風險因子，包括摔倒、活動能力下降、不能自理、需住老人院護理、死亡。
Cognitive impairment complicates diagnosis and requires additional care giving to ensure safety.
認知損害使診斷復雜，為保證安全需要更多的照料。
Finally, a serious and common outcome of chronic diseases of aging is physical disability, defined as having difficulty or being dependent on others for the conduct of essential or personally meaningful activities of life, from basic self-care (e.g., bathing or toileting) to tasks required to live independently (e.g., shopping, preparing meals, or paying bills) to a full range of activities considered to be productive and/or personally meaningful.
最后，老年人慢性病嚴重又常見的結果是身體能力不足，描述為個人最基本的或有意義的日�；顒佑欣щy或不得不依靠別人幫助指導，從基本的自理（如洗澡或如廁)到獨立生活需要的各種任務（如購物、做飯、支付各種賬單)，到具有集體和／或個人意義的所有活動。
Of older adults, 40% report difficulty with tasks requiring mobility, and difficulty with mobility predicts the future development of difficulty in instrumental activities of daily living (IADL; household management tasks) and activities of daily living (ADL; basic self-care tasks).
在老年人中， 40%對需要運動的任務有困難，運動困難提示將來開展日常工具鍛煉（IADL；家庭護理項目)和目常鍛煉（ADL；基本自理項目)的困難。
In persons age 65 and other, difficulty with IADL is reported by 20%, and difficulty with ADL is reported by 11%; for both, the prevalence increases with age. prevalence 流行
大于65歲的老人或其它人，IADL困難報導為20%，ADL困難報導為11%；隨年齡增加兩個都困難成為普遍現象。
People who have difficulty with tasks of IADL and ADL are at high risk of becoming dependent.
IADL和ADL困難的人處于不能自理演變的高風險中。
Of persons older than age 65, 5% reside in nursing homes, largely as a result of dependency in IADL and/or ADL secondary to severe disease. (reside 居住 nursing home 療養(yǎng)院)
小于65歲的老人中，5%住在療養(yǎng)院里，大多數是嚴重疾病后依賴IADL和ADL的結果。
Generally, woman live more years with disability, whereas men who become similarly disabled are more likely to die at a younger age.
一般來說，同樣的能力不足，男性常死得更年輕，女性比男性能多活幾年。
Although physical disability is primarily a result of chronic diseases and geriatric conditions, its onset and severity are modified by other factors, including treatments that control the underlying diseases, physical activity, nutrition, and smoking.
(Primarily 首先、起初、主要、、根本 onset 進攻、有力的開始、發(fā)作)
雖然身體能力不足是慢性疾病和年老狀態(tài)的一個主要結果，它的發(fā)生和嚴重程度被其它因素影響著，包括基礎疾病的治療和控制、身體鍛煉、營養(yǎng)和吸煙。
