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School of Medicine
Stay Strong: Four Ways to Beat the Frailty Risk
A factor known as frailty can predict bigger health problems down the road. So how is frailty defined, and how can you stay healthy through your senior years? Here’s what Johns Hopkins experts want you to know.
The spring in your step, the healthy foods on your plate and the optimistic feeling in your heart all help you feel great today. But did you know that nurturing these factors could also help you sidestep or even reverse frailty—the loss of strength, speed and energy that can whittle away at independence as a person ages?
An estimated 7 to 12 percent of Americans age 65 and older are considered frail. Risk rises with age—from one in 25 people between ages 65 and 74 to one in four of those older than age 84. That’s a concern, because frailty increases the risk of infections, illnesses that have to be treated in the hospital, falls and even disabilities. In a study of 594 older adults, Johns Hopkins researchers have found that frailty doubles the risk of surgical complications, lengthens hospital stays, and increases the odds of leaving independence behind (and moving to a nursing home or assisted-living facility) after a surgical procedure by as much as twentyfold.
Pioneering research at Johns Hopkins is helping doctors and their patients spot frailty sooner, for better health outcomes. “If we understand the underlying biomedical processes that create frailty, we can develop better interventions—from medications to lifestyle changes,” says Samuel Durso, M.D., director of geriatric medicine and gerontology at Johns Hopkins. “And fortunately, research already shows that some lifestyle steps can help.”
Identify frailty early.
You or a loved one may be considered frail if three or more of these criteria, developed by Johns Hopkins, apply to you:
- You’re shrinking. You’ve unintentionally lost 10 or more pounds in the past year.
- You feel weak. You have trouble standing without assistance or have reduced grip strength.
- You feel exhausted. Everything you do takes a big effort, or you just can’t get going three or more days most weeks.
- Your activity level is low. This includes formal exercise plus household chores and activities you do for fun.
- You walk slowly. Your pace is considered slow if the time it takes you more than six or seven seconds to walk 15 feet.
Discuss frailty with your doctor if you have concerns. “It’s also important to keep chronic conditions like high blood pressure, cholesterol and diabetes under control,” Durso notes.
Be active most days of the week.
“One cause of frailty is the age-related loss of muscle mass,” Durso explains. Research suggests that activities like walking and easy strength-training moves improve strength and reduce weakness – even in very old, frail adults. Every little bit helps, at any age.
Aim for three healthy meals a day that provide fruit, vegetables, protein, good fats, whole grains and low-fat dairy products. In one study, people who followed this approach (also known as the Mediterranean diet) faithfully were 74 percent less likely to become frail. Be sure to include enough muscle-nurturing protein. Women need about 46 grams per day, men about 56 grams—but many older people don’t get quite enough. Good sources include:
- Low-fat milk (8 grams per 8 ounces)
- Meat, fish or poultry (about 21 grams in 3 ounces)
- Cooked dried beans (about 16 grams in a cup)
- Yogurt (11 grams in 8 ounces of regular yogurt, 23 grams in 8 ounces of Greek yogurt)
Keep your mind active, your attitude optimistic.
Positive feelings were shown to translate into a lower risk of frailty in one study. “Staying socially connected with others and continuing to learn may also help,” Durso says. “Johns Hopkins research has found that those factors may explain why older volunteers who tutor in elementary schools sharpen their own thinking skills and improve their physical functioning too.”
Assisted living: A place for adults to live who do not need full-time nursing care but do need help with everyday tasks, such as dressing, bathing, eating or using the bathroom. Residents often need help due to memory disorders, incontinence or mobility issues. Centers offer a homelike atmosphere, providing meals, housekeeping, laundry, recreational activities, transportation and assistance 24 hours a day.
Mediterranean diet: Traditional cuisine of countries bordering the Mediterranean Sea, shown to reduce the risk for heart disease, diabetes, some cancers and dementia. On the menu: Plenty of fruits, vegetables and beans, along with olive oil, nuts, whole grains, seafood; moderate amounts of low-fat yogurt, low-fat cheese and poultry; small amounts of red meat and sweets; and wine, in moderation, with meals.
Muscle mass: Your muscles contract to power movements, and their mass refers to their size. The greater your muscle mass, the larger and denser your muscles are. The related term lean body mass is the weight of your muscles, bones, ligaments, tendons and internal organs.
Whole grains: Grains such as whole wheat, brown rice and barley still have their fiber-rich outer shell, called the bran, and inner germ. It provides vitamins, minerals and good fats. Choosing whole grain side dishes, cereals, breads and more may lower the risk for heart disease, type 2 diabetes and cancer and improve digestion, too.