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How To Avoid Frailty As We Age

13 September 2021

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Frailty can be loosely thought of as a decrease in easy movement, strength, energy and robust health in our senior years. Frailty has also been identified as a risk factor for dementia. Many forms of cancer are more debilitating for the frail than for those who are robust. Patients who meet the criteria for frailty have poorer outcomes when faced with any stress, like disease or surgery. Frailty is a predictor of increased hospitalization rates, falls and mortality. Those who are frail suffer more severe illness when exposed to pneumonia, influenza or COVID-19.  

An estimated 7-12 percent of Americans who are 65 or older are frail. Our risk for becoming frail increases as we age. One in 25 people aged 65 to 74 are frail: that number jumps to one in four in those 84 and older. 

Frailty makes daily life more difficult, uncomfortable and dangerous. Frailty syndrome is a diagnosis defined by age-related decreases in normal/daily function. It sounds a little vague, but what it comes down to is loss of muscle, stamina, endurance, general fitness and sometimes weight. Diagnostic criteria also include easy exhaustion, slowness and low levels of physical activity. The definition also may include the presence of two or more chronic diseases such as arthritis, heart disease, cancer or others.

When a person has three or more of a combination of the chronic diseases and other diagnostic criteria, they are considered to be frail.  

What are the signs of frailty?

Muscle weakness. Trouble standing without assistance or decreased grip strength are indicators of weakness. Others include difficulty lifting an object off a high shelf, rising from a chair or brushing your hair.  

Weight loss, specifically an unintentional loss of 10 or more pounds in the past year.

Exhaustion: Feeling as if everything you do takes a huge effort or if you just can’t get going three days a week or more? You may be suffering from exhaustion.

Slowed walking. If it takes more than six or seven seconds to walk 15 feet, that is considered to be dangerously slow. Walking speed studies shows that an older person's pace, along with their age and gender, can predict their life expectancy.

Low activity. This includes a decrease in accomplishing household chores, things you do for fun and formal exercise.

These signs can create a vicious cycle. Undernutrition leads to weight loss, which leads to loss of strength. Loss of strength, in turn, makes any activity less appealing and more exhausting. All of these contribute to falls, immobilization and decreased independence. 

How can we prevent or decrease frailty? 

Frailty is a result of aging but not all of us will be (or are) frail as we age. Partial or significant reversal is possible.

Be active most days of the week. The most important preventive strategy to reduce or prevent frailty is to exercise regularly. Be sure to address major muscle groups. If you walk, run, swim or enjoy other forms of cardio, balance that exercise with some light weightlifting, push-ups and sit-ups to strengthen your arms and abdominal muscles, respectively. Regular exercisers are less likely to become frail and people who are frail and can improve with exercise. Research indicates that even moderate activities like gentle strength training and strolling after dinner improve strength and reduce weakness, even among the already-frail and the very old. Every effort helps, no matter your age.  

Eat well. Eating well means drinking plenty of water and eating nutritious foods and eating enough of them. The goal should be three healthy meals a day, plus two snacks, containing a balance of good fats, protein, fiber and nutrients. Eating fruits and vegetables, whole grains, low-fat dairy products (this approach is often referred to as the Mediterranean diet). 

Protein is important. Generally speaking, men need about 56 grams a day; women need 46. Good sources of protein are low-fat milk (8 grams per 8 ounces); cooked dried beans (16 grams per cup); meat/poultry/fish (21 grams per three ounces); and yogurt (11 grams in 8 ounces of regular yogurt and 23 grams in 8 ounces of Greek yogurt).

Keep your attitude positive and your mind active. Psychology Today reports that recently, researchers have identified that having positive self-perceptions about the benefits of getting older can create a self-fulfilling prophecy by helping someone stay mentally, physically, and psychologically younger. 

Optimistic people have better mobility as they age and are more likely to be able to perform their activities of daily living. Research has found that we walk faster, think sharper and remain more physically fit the more positive our outlook.

Ways to keep your mind active and sharp include the following.

  • staying physically active
  • getting enough sleep
  • not smoking
  • having good social connections
  • limiting alcohol to no more than one drink a day
  • eating a Mediterranean style diet.

Those are the basics. To really ramp up your efforts, here are a few tips.

Learn.  Harvard Medical School experts explain that advanced education may help keep memory strong by getting people into the habit of being mentally active. Challenging your brain with mental exercise is believed to help maintain individual brain cells and stimulate communication among them. Ways to do that include Pursuing a hobby, learning a new skill, volunteering or mentoring are additional ways to keep your mind sharp.

Don’t believe everything you think! People who believe that they are not in control of their memory function — joking about "senior moments" too often, perhaps — are less likely to work at maintaining or improving their memory skills and therefore are more likely to experience cognitive decline.

Middle-aged and older learners do worse on memory tasks when they're exposed to negative stereotypes about aging and memory, and better when the messages are positive about memory preservation into old age. If you believe you can improve and you translate that belief into practice, you have a better chance of keeping your mind sharp.

Use your whole brain – and all of your senses. The more senses you use in learning something, the more of your brain that will be involved in retaining the memory. In one study, adults were shown a series of emotionally neutral images, each presented along with a smell. Later, they were shown a set of images, this time without odors, and asked to indicate which they'd seen before. They had excellent recall for all odor-paired pictures, and especially for those associated with pleasant smells. 

Have fun with a jigsaw puzzle or card game. Working on a jigsaw puzzle is a terrific way to strengthen your gray matter. When putting together a jigsaw puzzle, you have to look at different pieces and figure out where they fit within the larger picture. You’ve got to analyze, visualize and strategize. Similarly a quick card game can lead to greater brain volume in several regions of the brain. The same study also found that a game of cards could improve memory and thinking skills. 


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