Have you learned some new or interesting information related to “being elderly” over the past few weeks? I hope you have gleaned a fact or two that will be beneficial.

Sometime during our lives, all of us have probably known someone (regardless of age) who was considered “frail.” I am thinking of a young woman who appeared to be “easily breakable.” I would have never played any sport against her due to my fear of harming her. I think you get the picture.

While doing research on being elderly, I came across some material that referred to a new concept, at least for me: frailty syndrome. This concept has emerged in the geriatric medical community over the past fifteen years.

• Frailty – the condition of being weak and delicate
• Syndrome – a group of symptoms which consistently occur together, or a condition characterized by a set of associated symptoms

Defined as age-related deficits in normal body system function, a diagnosis is not made on precise signs but on an overview of several appraisals including decreased muscle mass, loss of endurance, overall health status, and sometimes weight loss. The presence of chronic diseases such as arthritis, heart disease and cancer are also considered.

Some of the indicators include weakness (which is a synonym for frailty), lethargy, lack of physical activity, poor balance, slow gait speed, visual and cognitive impairments and sometimes weight loss. Doctors screen for frailty with tests like timing a short walk (such as down a hallway) or asking the patient to grip his hand. (I’m pleased to report the last time I was asked to do this, the doctor responded with an “ouch.”) A specific indicator is the loss of muscle mass and strength, a natural part of aging known as sarcopenia. 

Here is some good news. Although the occurrence of this syndrome is a result of growing older, not all elderly people will face this challenge. The rate of those over age 65 in the U.S. who are diagnosed with frailty averages about 10 percent with that percentage increasing with age. For example, only about 4 percent of those ages 65 to 74 are identified as frail while this number increases to about 25 percent in the 85 and older group. The diagnosis of frailty syndrome is higher in women. Why? The same reason women also have a higher incidence of Alzheimer’s and other age-related diseases – they have a longer life expectancy and therefor greater liability.

In addition to age, research is focusing on several theories as to what actually causes frailty. Suggestions include chronic inflammation, changes in the aging immune system, and age-related levels of hormones, specifically less estrogen in women and less testosterone in men. The part that an elevated cortisol (the body’s main stress hormone) level plays in frailty is being studied. Low levels of Vitamin D may also be a contributing factor. 

A diagnosis of frailty syndrome is concerning because it predicts a less positive outcome when the patient develops a new illness, requires surgery, or even when exposed to contagious illnesses such as influenza and COVID. Falls and hospitalizations are more common. Some types of cancer are more ravaging in the frail than the strong.

Risks factors beyond growing old include genetics, other disease processes and lifestyle.

Not surprisingly, the most important step a person can take to prevent frailty is to stay active and commit to regular exercise that specifically addresses major muscle groups. While exercise is also considered a treatment, it is best not to wait until the diagnosis is made to begin a regular exercise routine. Ask your doctor to advise you concerning any new physical activity.

As we are learning more and more about food and its effects on our various body systems, we will be wise to check-out and adhere to sound nutritional advice. Food should not be viewed as entertainment but as nourishment for our bodies. A new mindset about what and how we eat is imperative for good health and longevity.

When someone receives a diagnosis of frailty syndrome, it is recommended that a geriatric team approach be adopted that includes physician, nurse, therapists, pharmacist and of course, caregiver. Working together, the goal should be to help the frail become strong.