Frailty is a health condition that increases risks of poor health, falls, disability, and death in older adults. Signs of frailty include weakness, weight loss, slow walking speed, exhaustion, and low levels of activity. As our population ages, scientists expect that more and more of us will need to address frailty and its associated health concerns.
Physical activity includes walking and other gentle forms of exercise. It is proven to improve health. Physical activity can lower the risk of many chronic diseases, including type 2 diabetes, heart disease, several cancers, and depression. Exercise also can improve your ability to perform your daily activities and can lower your risk of death from heart disease. In frail older adults, physical activity has been shown to improve strength, balance, agility (the ability to move quickly and easily), walking speed, and muscle mass (the amount of muscle you have in your body). These are all key functions tied to frailty.
Researchers recently reviewed a number of studies about exercise in frail older adults. The review found a number of studies that showed exercise helped reduce falls, improved walking ability, improved balance or increased muscle strength. However, we still don't know whether physical activity can reduce death among frail older adults.
Researchers recently designed a study to fill that knowledge gap by exploring whether physical activity could lower the high rate of death associated with frailty in older people. Their study was published in the Journal of the American Geriatrics Society.
The researchers used information from the UAM (Universidad Autonoma de Madrid) study, which included people 60-years-old and older who lived at home in Spain.
The 3,896 study participants were selected according to sex and age. Information was collected at the participants' homes through personal interviews, and physical examinations were performed by trained personnel.
Researchers assessed how much physical activity the participants did by asking whether they were generally inactive during their leisure time, or engaged in physical activity occasionally, several times a month, or several times a week.
Frailty was determined with the FRAIL scale, which measures five components of frailty: Fatigue, low Resistance (ability to maintain an effort, such as climbing stairs), limitation in the Ability to walk several hundred yards, Illness, and weight Loss.
Researchers reported that, of the participants:
- 12 percent reported having fatigue
- 7 percent had low resistance
- 4 percent had difficulties walking
- 2 percent had experienced weight loss
- 2 percent were sick
- 52 percent of the study participants were in robust health
- 4 percent were pre-frail (the medical term for a weakened state of health before someone is considered frail)
- 6 percent were frail
The study's follow-up period was 14 years. During that time, 1,801 participants died (46% of total participants), including 672 due to cardiovascular disease.
Compared with robust participants, pre-frail and frail people had a higher risk of death from cardiovascular disease. Having any one of the five components of the FRAIL scale was linked to a higher risk of mortality from any cause.
The researchers said that being pre-frail or frail could be linked to a higher risk of death from cardiovascular disease. However, being physically active was linked to a lower risk for death among pre-frail and frail individuals. What's more, deaths from cardiovascular disease in people who were physically active but also frail were similar to levels for pre-frail and inactive people.
The researchers said their findings suggest that physical activity might partly reduce the increased risk of death associated with frailty in older adults.
Know this: It's never too late to become active. Before starting on a new exercise program, check with your healthcare provider to make sure it's safe for you to do so. For the vast majority of people, the benefits of exercise far outweigh the risks.
Tips: Choose an exercise you enjoy. If you learn something new or exercise with a partner or in a group, so much the better!
This summary is from "Physical activity and the association of frailty with all-cause and cardiovascular mortality in older adults: a population-based prospective cohort study." It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Sara Higueras-Fresnillo, MSc; Verónica Cabanas-Sánchez, PhD; Esther Lopez-Garcia, PhD; Irene Esteban-Cornejo, PhD; José R. Banegas, MD, PhD; Kabir P. Sadarangani, MSc; Fernando Rodríguez-Artalejo, MD, PhD; and David Martinez-Gomez, PhD.
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This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit http://www.
About the Journal of the American Geriatrics Society
Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging insights on principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most impactful publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.
About the American Geriatrics Society
Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has--for 75 years--worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.