Frailty is a syndrome marked by a reduced ability to cope with stressors, which leads to a higher risk of negative health outcomes such as falls and hospitalizations. It is characterized by weakness, muscle mass loss, balance issues, and weight loss and affects approximately 10% of people aged 65 and older, and its prevalence increases in older age groups.
What is frailty?
Frailty is a syndrome characterized by a decreased ability to adapt to stressors, increasing the risk of adverse health outcomes (falls, hospitalizations, death, etc.). There can be many causes of frailty, but the effects are weakness, loss of muscle mass, loss of balance, and weight loss. Approximately 10% of people ≥65 years old are frail, increasing to 15.7% in people 80–84 years old, and 26.1% in people ≥85 years old.[1]
What are the main signs and symptoms of frailty?
People with frailty experience decreased energy, strength, and balance; weight loss; and trouble performing activities of daily living, such as showering, brushing teeth, and getting dressed. Correspondingly, when people with frailty experience physical or emotional stresses, such as death of a loved one, illness, or injury, their physical capacity can decline rapidly.
What are some of the main medical treatments for frailty?
Since people with frailty manage multiple health conditions, are vulnerable to adverse health outcomes, and require additional social support, treatment is multimodal and should treat the following components:[4]
- Medical conditions (e.g., diabetes, cardiovascular disease)
- Mental health
- Cognitive impairment
- Decreased mobility
- Participation in life roles
- Social support systems
Have any supplements been studied for frailty?
On their own, protein[5], Vitamin D[6], and DHEA[7], show no effect on frailty status. One study found that milk fat globule membrane supplementation in combination with exercise improved frailty status.[8] A meta-analysis of randomized controlled trials found that a combination of protein supplementation and exercise can also mitigate the physical aspects of frailty.[9]
How could diet affect frailty?
Malnutrition is the predominant concern among people who are frail. Ensuring that people with frailty have enough calories, protein, fruits, vegetables, and micronutrients in their diet can help reduce the risk of experiencing the adverse health outcomes associated with frailty.[10]
Are there any other treatments for frailty?
Exercise is another tool that can improve physical function and prevent adverse health outcomes (i.e., falls) in people with frailty. Current guidelines recommend that people with frailty should undergo a physical activity program consisting of aerobic, balance, and resistance training.[11] Gentler forms of exercise, such as Tai Chi, may also be helpful for people with frailty.[12][13] Since there are no recommendations for the optimal frequency, intensity, or duration of an exercise program for frailty, the program should be tailored to the individual's health goals and physical capacity.
What causes frailty?
There is no one cause for frailty. It is a multifaceted disease that can arise from chronic health conditions (e.g., cardiovascular disease, dementia, sarcopenia, type-2-diabetes), aging, or psychosocial factors.
Examine Database: Frailty
Research FeedRead all studies
Does exercising with music improve the health of older adults with frailty?
In this meta-analysis of randomized controlled trials and nonrandomized controlled trials, exercise with music reduced frailty and inconsistently improved depression symptoms but did not improve timed up and go (TUG) or handgrip strength.
Does protein powder enhance the effect of resistance training on bone mineral content?
Multicomponent exercise interventions reduce frailty risk in older adults
A recipe for healthy aging: resistance training and protein shakes
Can a vitamin-rich diet support aging without frailty?
Frequently asked questions
What is frailty?
Frailty is a syndrome characterized by a decreased ability to adapt to stressors, increasing the risk of adverse health outcomes (falls, hospitalizations, death, etc.). There can be many causes of frailty, but the effects are weakness, loss of muscle mass, loss of balance, and weight loss. Approximately 10% of people ≥65 years old are frail, increasing to 15.7% in people 80–84 years old, and 26.1% in people ≥85 years old.[1]
What’s the difference between sarcopenia and frailty?
Quick answer:
Sarcopenia and frailty share symptoms like weakness, fatigue, and weight loss, but sarcopenia specifically involves decreased muscle mass and strength, whereas frailty is a broader syndrome that results from multiple health issues. Sarcopenia can contribute to the development of frailty.
Many symptoms of sarcopenia and frailty overlap. Both conditions feature weakness, fatigue, and unintentional weight loss. Sarcopenia is a condition that features decreased muscle mass and strength, while frailty is a complex syndrome that arises from multiple health problems. Thus, sarcopenia — which focuses on the size and function of muscle — can be one of the causes of frailty.
What are the main signs and symptoms of frailty?
The main signs and symptoms of frailty include decreased energy, strength, and balance; weight loss; and difficulty with daily activities like showering and dressing. Additionally, physical or emotional stresses can lead to a rapid decline in physical capacity.
People with frailty experience decreased energy, strength, and balance; weight loss; and trouble performing activities of daily living, such as showering, brushing teeth, and getting dressed. Correspondingly, when people with frailty experience physical or emotional stresses, such as death of a loved one, illness, or injury, their physical capacity can decline rapidly.
How is frailty diagnosed?
Frailty diagnosis lacks a standard consensus, but the Fried Phenotype model and the Frailty Index are the two most commonly used diagnostic criteria.
What are the Fried Phenotype model and the Frailty Index (FI) criteria?
Quick answer:
The Fried Phenotype model identifies frailty based on the presence of at least 3 of 5 criteria, including slow walking speed and poor grip strength. The Frailty Index quantifies frailty by calculating the ratio of an individual's accumulated health deficits to the total possible deficits; scores range from 0.1 to 1.0, and higher scores indicate greater frailty.
The Fried Phenotype model classifies an individual as frail if they meet at least three of the following five criteria [3]:
- Slow walking speed
- Poor grip strength
- Unintentional weight loss of >10 pounds in the past year
- Decreased physical activity
- Self-reported exhaustion
The Frailty Index (FI) describes frailty as the accumulation of health deficits (any symptom, disease, or abnormal laboratory findings), resulting in decreased physiological reserve. The sum of an individual's accumulated health deficits is divided by the total amount of possible health deficits within a population sample. The FI score ranges from 0.1–1.0. The higher the score, the more frail the individual.[2]
What are some of the main medical treatments for frailty?
The main medical treatments for frailty are multimodal and address various components, including medical conditions like diabetes and cardiovascular disease, mental health, cognitive impairment, decreased mobility, participation in life roles, and social support systems. This comprehensive approach is necessary due to the complexity of the health issues faced by people with frailty.
Since people with frailty manage multiple health conditions, are vulnerable to adverse health outcomes, and require additional social support, treatment is multimodal and should treat the following components:[4]
- Medical conditions (e.g., diabetes, cardiovascular disease)
- Mental health
- Cognitive impairment
- Decreased mobility
- Participation in life roles
- Social support systems
Have any supplements been studied for frailty?
Individual supplements like protein, vitamin D, and DHEA have shown no effect on frailty status. However, supplementation with milk fat globule membrane combined with exercise and a combination of protein supplementation and exercise have been found to improve frailty status.
On their own, protein[5], Vitamin D[6], and DHEA[7], show no effect on frailty status. One study found that milk fat globule membrane supplementation in combination with exercise improved frailty status.[8] A meta-analysis of randomized controlled trials found that a combination of protein supplementation and exercise can also mitigate the physical aspects of frailty.[9]
How could diet affect frailty?
Diet plays a crucial role in managing frailty because malnutrition is a significant concern. Adequate intakes of calories, protein, fruits, vegetables, and micronutrients can help mitigate the negative health effects associated with frailty.
Malnutrition is the predominant concern among people who are frail. Ensuring that people with frailty have enough calories, protein, fruits, vegetables, and micronutrients in their diet can help reduce the risk of experiencing the adverse health outcomes associated with frailty.[10]
Are there any other treatments for frailty?
Exercise (including aerobic, balance, and resistance training) is recommended to improve physical function and prevent adverse health outcomes in people with frailty. Tailoring the exercise program to the individual's health goals and physical capacity is essential, and gentler forms like tai chi may also be beneficial.
Exercise is another tool that can improve physical function and prevent adverse health outcomes (i.e., falls) in people with frailty. Current guidelines recommend that people with frailty should undergo a physical activity program consisting of aerobic, balance, and resistance training.[11] Gentler forms of exercise, such as Tai Chi, may also be helpful for people with frailty.[12][13] Since there are no recommendations for the optimal frequency, intensity, or duration of an exercise program for frailty, the program should be tailored to the individual's health goals and physical capacity.
What causes frailty?
Frailty is a multifaceted condition with no single cause; it arises from a combination of chronic health conditions, aging, and psychosocial factors. Examples of chronic conditions that can contribute to frailty include cardiovascular disease, dementia, sarcopenia, and type 2 diabetes.
There is no one cause for frailty. It is a multifaceted disease that can arise from chronic health conditions (e.g., cardiovascular disease, dementia, sarcopenia, type-2-diabetes), aging, or psychosocial factors.
References
Examine Database References
- Cognitive Decline - Muller M, van den Beld AW, van der Schouw YT, Grobbee DE, Lamberts SWEffects of dehydroepiandrosterone and atamestane supplementation on frailty in elderly menJ Clin Endocrinol Metab.(2006 Oct)
- Estrogen - Kenny AM, Boxer RS, Kleppinger A, Brindisi J, Feinn R, Burleson JADehydroepiandrosterone combined with exercise improves muscle strength and physical function in frail older womenJ Am Geriatr Soc.(2010 Sep)
- Muscle Mass - Nasimi N, Sohrabi Z, Nunes EA, Sadeghi E, Jamshidi S, Gholami Z, Akbarzadeh M, Faghih S, Akhlaghi M, Phillips SMWhey Protein Supplementation with or without Vitamin D on Sarcopenia-Related Measures: A Systematic Review and Meta-Analysis.Adv Nutr.(2023-Jul)
- Muscle Mass - Medium-chain triglycerides (8:0 and 10:0) increase muscle mass and function in frail older adults: a combined data analysis of clinical trials.()
- Lower Body Strength - A Randomized, Double-Blind, Controlled Trial Assessing If Medium-Chain Triglycerides in Combination with Moderate-Intensity Exercise Increase Muscle Strength in Healthy Middle-Aged and Older Adults .()
- Functionality in Elderly or Injured - Rodondi A, Ammann P, Ghilardi-Beuret S, Rizzoli RZinc increases the effects of essential amino acids-whey protein supplements in frail elderlyJ Nutr Health Aging.(2009 Jun)
- Fracture Risk - Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, Thoma A, Kiel DP, Henschkowski JPrevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trialsArch Intern Med.(2009 Mar 23)