{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T07:25:21Z","timestamp":1787297121531,"version":"build-2736575974"},"reference-count":66,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01-AG082341"],"award-info":[{"award-number":["R01-AG082341"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Johns Hopkins University Older Americans Independence Center","award":["P30-AG021334"],"award-info":[{"award-number":["P30-AG021334"]}]},{"name":"Johns Hopkins University Older Americans Independence Center","award":["K24-AI120834"],"award-info":[{"award-number":["K24-AI120834"]}]},{"name":"Johns Hopkins University Older Americans Independence Center","award":["K23-AG072042"],"award-info":[{"award-number":["K23-AG072042"]}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["IN-TRAC P30-AI-168439"],"award-info":[{"award-number":["IN-TRAC P30-AI-168439"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["CTSA UM1-TR004906"],"award-info":[{"award-number":["CTSA UM1-TR004906"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UTHealth Houston Institute on Aging"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Tuberculosis (TB) causes profound systemic illness, and many survivors experience long-term sequelae associated with disability and premature mortality. Current TB severity indicators capture isolated aspects of disease and may not reflect the integrated physiological impact of infection on the host. Frailty, a multidimensional syndrome characterized by reduced physiological reserve and increased vulnerability to stressors, predicts adverse outcomes and guides clinical management in geriatrics. We propose frailty as an integrative framework for understanding the systemic effects of TB across the life course, encompassing disease severity, recovery, and long-term sequelae. We discuss biological mechanisms through which Mycobacterium tuberculosis infection may erode physiological reserve and promote frailty, including inflammation and metabolic and endocrine dysregulation. We further consider how frailty assessment could improve risk stratification and guide individualized supportive care to mitigate post-TB sequelae. Unlike aging-related frailty, TB-associated frailty may provide a unique opportunity to study mechanisms of resilience and recovery following severe infection.<\/jats:p>\n                  <jats:p>Frailty offers a multidimensional framework for understanding the systemic impact of tuberculosis (TB) beyond conventional disease severity measures, with potential to improve risk stratification, guide individualized supportive care, and evaluate recovery and post-TB sequelae.<\/jats:p>","DOI":"10.1093\/infdis\/jiag415","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:25:17Z","timestamp":1786706717000},"source":"Crossref","is-referenced-by-count":0,"title":["Frailty as a Framework to Understand Tuberculosis Severity, Recovery, and Sequelae"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9481-3381","authenticated-orcid":false,"given":"Yoscelina E","family":"Martinez-Lopez","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston , Brownsville and Houston Campus, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4228-2054","authenticated-orcid":false,"given":"Benjamin W","family":"Black","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston , Brownsville and Houston Campus, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7902-7745","authenticated-orcid":false,"given":"Jessica","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Geriatric and Palliative Medicine and Institute on Aging, University of Texas Health Science Center at Houston , Houston Campus, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J","family":"Buta","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University , Baltimore, Maryland ,","place":["USA"]},{"name":"Center on Aging and Health, Johns Hopkins Medical Institutions , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0678-9682","authenticated-orcid":false,"given":"Lisa Y","family":"Armitige","sequence":"additional","affiliation":[{"name":"Heartland National TB Center and Division of Adult Infectious Diseases, University of Texas Health Science Center at Tyler , Tyler, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7995-8160","authenticated-orcid":false,"given":"William A","family":"Fountain","sequence":"additional","affiliation":[{"name":"School of Health and Human Sciences, Indiana University , Indianapolis, Indiana ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2250-9401","authenticated-orcid":false,"given":"Rafael","family":"Samper","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston , Brownsville and Houston Campus, Texas ,","place":["USA"]},{"name":"Division of Geriatric and Palliative Medicine and Institute on Aging, University of Texas Health Science Center at Houston , Houston Campus, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aanand D","family":"Naik","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston , Brownsville and Houston Campus, Texas ,","place":["USA"]},{"name":"Division of Geriatric and Palliative Medicine and Institute on Aging, University of Texas Health Science Center at Houston , Houston Campus, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Turner","sequence":"additional","affiliation":[{"name":"Abigail Wexner Research Institute, Nationwide Children's Hospital , Columbus, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8818-7444","authenticated-orcid":false,"given":"Qian-Li","family":"Xue","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University , Baltimore, Maryland ,","place":["USA"]},{"name":"Center on Aging and Health, Johns Hopkins Medical Institutions , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8599-278X","authenticated-orcid":false,"given":"Todd T","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, School of Medicine, Johns Hopkins University , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3743-9098","authenticated-orcid":false,"given":"Blanca I","family":"Restrepo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston , Brownsville and Houston Campus, Texas ,","place":["USA"]},{"name":"South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley , Edinburg, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"2026082103061056800_jiag415-B1","first-page":"433","article-title":"Frailty syndrome: an overview","volume":"9","author":"Chen","year":"2014","journal-title":"Clin Interv 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