Understanding and Dealing with Frailty at Any Age
The number one reason seniors seek medical health care is frailty, which is a very general term. In this first article we’ll look at the definition of frailty, how it affects us as we age and one important symptom we should look out for.
What Frailty Means to the General Public
To most people, frailty pertains to a person who is weakening, less able to take care of their own needs. The dictionary agrees and simply says that frailty is a condition of being weak and delicate.
In reality, though, frailty begins much earlier than our senior years, and the medical community has a much more extensive, complex definition.
What Frailty Means to the Medical Community
According to the Review Annales de Gerontologie authors Jean-Pierre Michel, Pierre-Olivier Lang and Dina Zekry, “Frailty is an extended process of increasing vulnerability, predisposing [one] to functional decline and ultimately leading to death. Different presentations of frailty are encountered by the clinician, as a result of the combination of factors such (as) age, gender, lifestyle, socio-economic background, co-morbidities, and affective, cognitive or sensory impairments.”
In other words, frailty is a condition, a medical syndrome or a group of symptoms that collectively characterize it as a disease. But some elderly never get frail.
How Does Frailty Affect Old Age?
Frailty appears as an age-related physiologic vulnerability resulting from an impaired homeostatic reserve. Homeostatic here means the tendency of the body to remain stable as it compensates for environmental changes.
The body is a marvelous machine, always repairing itself. But as our body becomes less able to withstand stress, it becomes unstable, leading to a higher risk of frailty-related complications.
These include falls, functional decline, poly-medication, an increased risk of hospitalization, cross infection, institutionalization and eventually, death.
One is pre-frail when one has sufficient physiological reserves for acute diseases, injury or stress. The patient recovers completely.
One is frail, though, when one does not recover completely after any new acute disease, injury or stress. I have recurring back problems and using this definition I worry I could be diagnosed as frail.
What My Doctor Prescribed
My doctor suggested that I was losing too much muscle mass. He prescribed drinking a protein shake before any type of exercise, and lifting weights. He was especially concerned about my legs.
I paid attention to the problem but decided that more walking would do the trick. I also ditched the protein powder. I was wrong. After three months, he measured and I came up short.
Dr. Emhof wanted to see me again in another three months to measure my progress. Each time he used a body composition monitor to measure muscle mass throughout my body.
So in three months, I was back and had made only a little progress. He stressed weight training again – five reps of 15 or more – about a 15-minute workout at least two times a week. Begrudgingly, I joined a gym for the first time in 20 years.
What Leads to Loss of Muscle Mass?
Loss of muscle mass begins early. As we engage in lesser activity, this leads to a loss of as much as 3% to 5% of muscle mass each decade after age 30. This lessens our strength and mobility.
Remember the term homeostasis? Our body’s damage repair processes start out really good, but as time goes by, the damages accumulate. The repair process wanes. As a lot of things go wrong, everything begins to double and the body cannot repair itself.
According to medical science, our muscles grow and strengthen until about age 30, but then the process reverses itself. We begin to lose muscle mass and function, losing some muscle mass even if we remain active.
What Does Loss of Muscle Mass Lead to?
The medical term describing loss of muscle mass is sarcopenia. This process typically happens faster around the age of 75, though it can begin as early as 65. Loss of muscle mass is a characteristic of frailty.
Also around the age of 75, a person’s overall health can spiral downward, leading to weakness and loss of stamina. Physical inactivity increases and muscle mass declines faster. This is mostly prevalent in those of us who are inactive, but it can affect active adults, too.
This causes other symptoms, such a reduction of the nerve cells that normally send signals to our brain to begin movement. There can also be a decrease in hormones, such as testosterone.
Loss of muscle mass can lead to the body’s inability to turn protein into energy, and even more important, an inability to get enough protein and calories a day to build body mass. We notice this when an individual stops eating and begins to lose weight.
In the next segment of this post, we’ll talk more about muscle mass, what to look for, and how to reverse its loss. We will also talk about how doctor’s measure frailty.
Do you worry about being frail and losing your strength and balance as you get older? Is the loss of muscle mass something that is affecting you in your 60s? Please share your observations in the comments below.