Prevention of Frailty

Frailty is loss of physiologic reserve, which makes people susceptible to disability due to minor stresses (1). Common features of frailty include weakness, slowed motor function, weight loss, muscle wasting (sarcopenia), exercise intolerance, frequent falls, immobility, incontinence, and frequent exacerbations of chronic diseases.

Exercise and a healthy diet are recommended for preventing or reducing frailty (2). Older adults 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 and muscle 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.

Nutritional counseling and supplementation appear to have beneficial effects on patients with frailty (3). Adequate protein intake is also recommended when combined with exercise. The optimal level of protein intake is unknown, but some experts recommend an intake of 1.0 to 1.2 g/kg a day in healthy older adults without chronic kidney disease (4).