frailty

Frailty is more often found in the over 70 population than the under 40, however, all older persons are not frail and some young persons are. There is no age group for which frailty is a destiny. Frailty is often associated with a chronic disease condition and with lack of physical activity. Or as I used to say to people I worked with who wanted a wheel chair - without being paralyzed or injured - "if you stop walking, you are going to stop walking."

The word frail may elicit an image - it is probably of a thin person, stooped over, perhaps pale and smalled boned. One of the criteria for frailty IS weight loss, unintentional weight loss, but NOT low weight. According to an article published in the JAMA in November 2006, a frail individual is one who has at least three of the following conditions:
- Unintentional weight loss
-Low physical activity
-Muscle weakness (little grip strength)
-Slowed performance (walks very slow)
-Fatigue or poor endurance (feels exhausted)

Chronic disease conditions may limit a person's desire or ability to exercise, but exercise is exactly what is recommended to prevent or treat this condition. According to an article in the Jan-March 2010 ACSM's Certified News, persons who have this medical condition should have a supervised and dynamic exercise prescription. If the person is overweight, as obesity is a condition which leads to limiting chronic diseases (i.e arthritis, diabetes, heart disease, PAD -etc), weight loss is recommended as well.

ACSM recommends a program that first starts where the person is - so their cardiorespiratory function is tested - perhaps by assessing ability to take a six minute walk, their grip strength and flexibility should also be measured prior to beginning. These pre tests not only help to know where to start, but also can show how far a person has come.

The best type of activity for frail persons is weight bearing - such as walking, while swimming or cycling would be second best. Weight training is essential and should be progressive ( this means that over time the weights should be increased) . Static stretching will help with flexibility, where as functional fitness, such as chair sits and balancing can help to prevent falls. Even Yoga and Tai Chi are offered as good movement exercises for the frail individual.

Loss of muscle mass occurs with disuse and a person could very well lose the ability to care for themselves or to live independently if they succomb to the fraility.

It is best to fight the urge to stay in bed and let Medicare buy you a sassy chair. Start with whatever physical activity you are capable of and do a little more everyday. Eat a well balanced, calorie controlled, nutritious diet and find the hale and hearty YOU.