Labeling an older adult as “frail” can be stigmatizing. Geriatric researchers have cautioned that the term is linked to “mental or moral weakness” and may become “the new cloak of ageism, a tool for discrimination and disempowerment applied to the most vulnerable.”

Despite its negative connotations, medical science uses the term frailty to describe a “state of increased vulnerability resulting from aging-associated decline in reserve and function across multiple physiologic systems such that the ability to cope with everyday or acute stressors is comprised.” The characteristics associated with frailty include loss of energy, reduced walking speed, limited physical activity, loss of muscle strength, and unintended weight loss.

Frailty places older adults at risk of dangerous falls and makes them more vulnerable to dementia and other diseases. Seniors who meet the medical definition of frailty are less likely to make a full recovery from minor events (such as a fall or illness) than when they were younger. Studies have associated frailty with an elevated risk for hospitalizations, nursing home admissions, and death.

While the prevalence of frailty in the senior population increases gradually with age, every human is different. Genetic, biological, environmental, and social factors, as well as lifestyle and access to healthcare, all affect the way we age. For that reason, geriatric researchers have concluded that “advanced age on its own does not necessarily mean vulnerability to negative health outcomes so typical of frailty.”

Frailty Treatment and Prevention

There is no standard clinical treatment for frailty. Studies of healthcare strategies to counteract the development of frailty have been inconclusive. The most consistent results suggest that exercise improves health outcomes for seniors who are deemed to be frail. 

Exercise programs are most effective when they include a menu of exercises designed to improve endurance, flexibility, and balance. Physician-supervised exercise programs that include resistance training to improve strength seem to achieve the best results.

Exercise is also an important frailty prevention strategy. Exercise keeps the body strong and reduces the risk that a fall or disease will cause a disability. A healthy diet is also important. The risk of diseases that contribute to frailty can be managed by eating more fruits, vegetables, and whole grains while reducing salt intake and consuming fewer ultra processed foods.

Predicting Frailty

A recent study suggests the possibility of predicting frailty-related health risks by measuring circadian rhythms. Disturbing the internal “clock” that governs the body’s desire to be active or to sleep can increase the risk of becoming frail. 

The study found that frailty typically develops more than six years after circadian rhythms are regularly disturbed. The study suggests that older adults might use wearable technology to measure circadian rhythms. Recognizing a disturbance of the rhythm might help older adults perform a reset by adjusting their daily routine or making lifestyle changes.

Help Older Adults Manage the Risk of Frailty

Johns Hopkins advises older adults and their loved ones to be alert for developing symptoms of frailty. When older adults have difficulty standing, take more than six or seven seconds to walk fifteen feet, constantly feel exhausted, experience an unintended weight loss of more than ten pounds in a year, or avoid physical activity, it is time to consult a physician.

Adult children and friends of aging adults can gently encourage them to take steps to maintain their independence by reducing their risk of developing symptoms of frailty. While it is difficult to change habits that have developed over a lifetime, adult children and friends can introduce older adults to food that is both nutritious and delicious. Friends and family can ask older adults to go shopping with them or to take a walk together. Every bit of exercise strengthens the body, regardless of age.