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Frailty is loss of physiologic reserve, which makes people susceptible to disability due to minor stresses. Common features of frailty include weakness, weight loss, muscle wasting (sarcopenia), exercise intolerance, frequent falls, immobility, incontinence, and frequent exacerbations of chronic diseases.
Exercise (see Exercise: Exercise in the Elderly) and a healthy diet (see Table 5: Prevention of Disease and Disability in the Elderly: Nutritional Recommendations for Prevention of Frailty ) are recommended for preventing or reducing frailty. Elderly people who engage in regular aerobic exercise (eg, walking, swimming, running) increase their life expectancy and have less functional decline than those who are sedentary. Mood and possibly cognitive function may also be improved. Weight training can help increase bone mass and reduce risk of falls and fractures. A healthy diet may prevent or reduce risk of many diseases that contribute to frailty, including breast and colon cancers, osteoporosis, obesity, and undernutrition; morbidity and mortality may also be reduced.
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Table 5
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| Nutritional Recommendations for Prevention of Frailty |
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Measure
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Description
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Rationale
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Low-fat diet
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Fats limited to less than about 20 g/day, with 6–10 g polyunsaturated (with ω-3s and ω-6s in equal proportions), ≤ 2 g saturated fats, and the rest as monounsaturated fats
Some sources of healthful oils: Oily fish (eg, tuna, salmon, mackerel, herring), certain vegetable oils (flaxseed, canola, soybean), flax seed, and walnuts
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Decreases risk of cardiovascular disease
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Low Na diet
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Recommended limit of ≤ 2.4 g/day, which is difficult to maintain (for most elderly people, < 4 g is more reasonable)
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Lowers BP in some people
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High Ca diet and Ca supplements
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For the elderly, 1200–1500 mg/day (most American diets contain only 500–700 mg/day)
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Helps maintain bone density
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Adequate intake of vitamins and minerals
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Largely by eating fruits and vegetables
Supplementation with vitamin D (800 IU/day) for people with average or low dietary Ca
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For vitamin D, prevents bone loss
May prevent various chronic diseases
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High-fiber diet
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Best obtained by eating fruits, vegetables, and grains
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May prevent colon cancer
Has a beneficial effect on serum lipids
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Moderate alcohol intake
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About 1 oz of alcohol/day (more can be harmful)
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May decrease risk of cardiovascular disease
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Last full review/revision December 2009 by James T. Pacala, MD, MS
Content last modified July 2012
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