Dear Doctors: My mom saw a news story about frailty and worries it will happen to her. She’s 83 and is vital for her age. She does senior yoga and walks most days. She does take medication for high blood pressure and is prediabetic. Are either of those involved in being frail? Can it be prevented?
Dear Reader: The term “frailty” is often misunderstood. It used to refer primarily to physical weakness. While this is often a key part of frailty, a newer understanding is more nuanced. When someone is frail, it means their overall health has become less resilient. This makes them more vulnerable to poor outcomes if they get ill, injured or have a health challenge or even an environmental stressor. Though frailty is associated with growing older, it can actually happen at any age.
Frailty is now understood to be a syndrome. This is a group of symptoms that often occur together and are characteristic of a recognizable state of health. In frailty, muscle weakness is a key symptom. It can show up as weaker grip strength, poor balance, slowed walking speed, less endurance, and less flexibility and agility. People who are frail often have other health conditions. They may have bone loss, poor blood glucose control, high blood pressure, vision and hearing loss, and changes to cognition. All together, these symptoms put them at higher risk of physical injuries, such as a fall. Lack of physical resilience can turn even a minor accident or illness into hospitalization. This can trigger a steep physical and mental decline.
It’s also important to know frailty exists on a spectrum from mild to severe. People with one or two symptoms may be considered prefrail. Those with several symptoms are considered frail. Because it is a collection of symptoms, frailty can fly under the radar. For many people, it is only when a crisis occurs that the underlying frailty is noticed. With that in mind, we would encourage your mother to see her healthcare provider for an assessment.
The good news about frailty is that, when identified early, it can be slowed or even reversed. A team of researchers from Japan and London analyzed medical data from 42,775 older adults who ranged from robust to frail. They found that 14% improved their status, slightly more than half remained stable, and the rest became frailer. As expected, the prefrail group had the highest rates of improvement.
When it comes to preventing, slowing or reversing frailty, a few lifestyle factors come into play. Regular physical activity is the biggest one. Even the walking your mother is already doing improves mobility, balance and endurance. Resistance-based exercises to build and maintain muscle mass are also very helpful. Another factor is a balanced diet with plenty of protein and fresh vegetables, leafy greens and fruit. Add regular eye, hearing and medical checks, and your mother can know she is doing her best to reduce the risk of frailty.
(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
