Dealing With Frailty
Understand the most misunderstood human condition - FRAILTY

By Julian Mokhtar

Frailty is the condition of declining health and functionality in older people.

How often have you heard the phrase “old and frail”? The image it brings to mind is of advanced age as well as physical and mental weakness or disability. An image of an old person walking with the aid of a walking stick or frame, in a wheelchair, or even bedridden — unable to perform the activities that people in their younger age take for granted. On the mental side we get the image of old people being forgetful, unable to think or communicate clearly, and becoming what we in Malaysia call “nyanyok” or senile. This weakening and degeneration is usually considered an inevitable part of growing old, yet few understand how frailty can develop, nor that its onset can be delayed and its effects made less severe. As a general definition, frailty is the condition of declining health and functionality in older people. Signs of frailty include weakness or loss of strength, slower movement, decreased activity, and unintended weight loss. These are partly the result of natural changes in our bodies as we grow older, such as decrease in muscle mass, less body flexibility, less efficient energy production in our cells, and a weakening immune system. Osteoporosis, or decrease in bone density, is another factor particularly for women. This leads to a vicious spiral. It may start with seemingly minor things like jars becoming a little more difficult to open, a little more effort needed to reach for something on a high shelf, climbing stairs becomes a little more tiring, it gets a little harder to get up from sitting or lying down. Muscle or joint aches and stiffness are felt a little more. So what do we do? The natural thing, of course. We start taking it a little bit easy, move a little less, stretch a little less, exert ourselves a little less until one day we find ourselves struggling to get up from the sofa. Mental frailty is also partially brought on by natural age-related changes in the brain such as a decrease in the number of brain cells and other changes in brain structure, as well as deteriorating sight, hearing, and sense of taste. Lack of interaction and mental stimulation amplifies the effects of the changes to an ageing brain. Disease or injury as well can be a major cause of frailty either setting in or increasing for those already becoming frail. In other words, an older person in an already weakened condition an illness such a flu can be severe and recovery will take longer. An injury from a fall or other mishap will take longer to heal. The result, again, is a vicious spiral. The illness or injury and the recovery period results in the individual becoming even weaker and less mobile, leading to higher vulnerability to illness or injury. The presence of other conditions such as high blood pressure, diabetes, or poor nutrition can further increase frailty.

Staying mentally and physically active can defer the onset of frailty by almost ten years.

The good news is that the onset of frailty can be held off, reversed to some extent if it’s already set in, and the severity in later years reduced. Good nutrition is important, of course. It’s also beneficial to remain active, exercise, basically keep moving as much as possible. This improves muscle strength, flexibility, gives the immune system a boost and promotes a general feeling of well-being. Mental activity and stimulation are equally important. The brain, like a muscle, benefits from being exercised. Social interaction, hobbies, or taking a course to learn something new are ways to maintain a sound mind. Thus, staying mentally and physically active can defer the onset of frailty by almost ten years. The average age for the normal onset of frailty is mid to late seventies, so by choosing to age healthily you could be in good shape through your eighties and even nineties.