19 May Frailty in Seniors

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What is Frailty?

Many seniors lead active and robust lives. However, there are a subset of older adults who no longer have that spring in their step. These seniors who appear very thin, tired, and weak may have a medical condition referred to as frailty. According to the National Institutes of Health, frailty is defined as a state of increased vulnerability resulting from age-related decline across multiple systems in the body.

Three of five following standards must be met for a diagnosis of frailty. This includes low grip strength/muscle weakness; low energy/fatigue; slowed walking speed; low physical activity; and/or unintentional weight loss. Frailty leads to an increase in poor health such as falls, disability, hospitalization, and death. A condition of pre-frailty occurs when two of these criteria are met.

Poor Outcomes

Being older does not mean you will be frail. However, a small subset of seniors are considered frail. Overall, says the NIH, among adults 65 years or older, the number of frail adults in community dwelling facilities ranges from 7-12%. Frailty increases with age to about 4% in the 65-74 age group and to 25% in people 85 years and older. Frailty is greater in women than men (8% vs. 5%). African Americans were more than twice as likely to be frail than Caucasians.

Once an elderly adult becomes frail the risk of poor health outcomes increases. Generally, this includes a greater chance of falling, heart disease, diabetes, and other age related conditions. Moreover, frail seniors have a general decline in function. Consequently, they are less able to get around and continue with their daily lives to maintain their independence.

The main signs to look for if you think you or an elderly loved one may have frailty are weight loss and low energy. Keep in mind, elderly people who are obese can also be frail. While some weight loss may occur in these individuals, a key indicator to look for is loss of muscle strength and low energy/fatigue.

Treatment

A diagnosis of frailty does not necessarily mean a serious health event will occur. It does, however, give people the opportunity to improve their health and help avoid more poor health outcomes. The best treatment to delay, reduce, or even reverse frailty (to some degree) is exercise. According to the NIH, exercise has a positive impact on almost all organs and systems in the body–especially the muscular, endocrine (system that regulates metabolism, sleep and mood, among others), and immune systems. Exercise will help almost immediately with the sense of fatigue that people have when frail.

A combination of different types of exercise are best including those that improve balance, offer cardiovascular benefits, and increase muscle strength. These types of exercises will help a frail person get in and out of a chair/car or be able to sit on a toilet–all important to help maintain independence as long as possible. Walk around the block, begin lifting 1 or 2 pound weights, or work with a physical therapist to give you a long-term exercise program to help treat frailty. Exercises that target hip and shoulder joints are also important to keep up mobility.

Research from the NIH shows diet is also important. Highly processed foods with empty calories and high sugar content can cause inflammation in the body which can increase frailty. The Mediterranean Diet, which focuses on plant based foods, nuts, beans, and whole grains with moderate amounts of dairy, poultry, eggs, seafood, and a small amount of red meat, has been shown to be effective in lessening frailty.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028599/

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