The aging process occurs in stages that are important to understand, but the driving factors behind them are still being studied. One important stage of the aging process is frailty.
This period of time is defined by a rapid shift in condition from the normal aging process to a state of disability marked by increased weight loss, weakness and decreased activity as a result of poor care outcomes. It’s an important time for older adults as the consequences for the ability to age gracefully are severe.
What is Frailty?
As defined by a paper published in the journal Clinics in Geriatric Medicine, “frailty manifests as an age-related, biological vulnerability to stressors and decreased physiological reserves yielding a limited capacity to maintain homeostasis.”
In other words, the body is unable to achieve consistency and balance in physiological processes. The paper goes on to outline the five criteria examined in identifying frailty:
- Self-reported exhaustion
- Unintentional weight loss
- Slow physical performance
- Decreased physical activity
Aging does often come with a failure of the same physiological processes, but the changes related to aging tend to be consistent throughout the body. With frailty, the failing processes tend to be concentrated more on energy metabolism and neuromuscular health specifically.
The consequences of frailty go beyond the physical symptoms though, having deeper seeded impacts on cognitive function in some cases. Essentially, this combination of mild cognitive impairment (MCI) and frailty has been renamed cognitive frailty and recent studies have begun to examine how this impacts the aging process and whether or not it can be reversed.
According to the Journal of Alzheimer’s Disease, researchers have proposed two subtypes of cognitive frailty: potentially reversible cognitive frailty, which is the combination of physical frailty and MCI, and reversible cognitive frailty, defined as “physical frailty and pre-MCI subjective cognitive decline.”
How Can Older Adults Avoid Frailty?
The important thing to realize here is that frailty is not an inevitable part of aging, but rather a medical condition that could be treated or prevented.
The weight loss and decrease in activity that comes with physical frailty leads to a loss of muscle mass. The process can be treated, according to various studies published in recent years, with an exercise training program and protein supplementation.
For older adults, a healthy diet and lifestyle choices that include physical activities, being smoke-free, engaging in a socially integrated lifestyle, maintenance of a proper body weight, and metabolic and vascular risk control including diabetes and blood pressure are valuable tools in preventing cognitive frailty.
Both physical frailty and cognitive frailty are two phenotypes of frailty that are quickly becoming targets for researchers looking to address dementia in its earlier stages.
Cognitive frailty has a potential for reversibility. Of course, at this stage, the prevention of cognitive frailty progression to dementia is only a hypothesis. But as previously noted, a variety of studies have noted the benefit of a healthy diet and regular exercise.
The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), is one which showed intervention combining Mediterranean diet, exercise, and brain stimulation slowed cognitive loss in older adults and it is well established that regular exercise decreases the effects of physical frailty and the risk of falls.