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JAMA Patient Page
November 8, 2006

Frailty in Older Adults

JAMA. 2006;296(18):2280. doi:10.1001/jama.296.18.2280

Frailty, commonly associated with aging, includes several characteristics (see below). Frail older adults are weak, often have many complex medical problems, have a lower ability for independent living, may have impaired mental abilities, and often require assistance for daily activities (dressing, eating, toileting, mobility). Most frail older adults are women (partly because women live longer than men), are more than 80 years old, and often receive care from an adult child. Because of the rapid rate of growth in the population aged 65 years and older, the number of frail elderly persons is increasing every year.

The November 8, 2006, issue of JAMA includes an article about care for frail older adults.

WHAT IS FRAILTY?

  • Low physical activity

  • Muscle weakness

  • Slowed performance

  • Fatigue or poor endurance

  • Unintentional weight loss

To be considered frail, a person must have 3 or more of these characteristics. Persons who are frail are more likely to become disabled, to be admitted to the hospital, and to have health problems. Research has shown that individuals who smoke, persons with depression or long-term medical problems, and those who are underweight are more likely to become frail. Frail older adults are more likely to develop infections because their immune systems do not work as well as in healthy older adults. Simple infections may cause more harm, even death, for a frail elderly person, than for for an individual of the same age who is healthy. Malnutrition is also common among frail older adults. Loss of muscle mass (more than with healthy aging) may result from a diet low in protein. Because of inability to plan and prepare their own meals, frail elderly individuals may not consume enough protein and calories to maintain their body weight and health.

PREVENTION

  • Get some physical activity into each day, structuring the exercise according to the person's abilities. Walking is useful to improve heart fitness, balance, and muscle mass. Exercises using resistance such as weights or bands build muscle and help to reduce joint stiffness and pain. Even small increases in fitness can improve symptoms of frailty.

  • Keeping the mind active is important for older adults. Crossword or number puzzles, reading, playing games, and socializing are all good ways to maintain mental sharpness.

  • Recognize and treat depression, other psychiatric illnesses, and medical problems to prevent progression of frailty.

  • Maintain good nutrition with a balanced diet including enough protein (to maintain muscle mass), fruits and vegetables, fiber, and fluids (especially in warmer climates).

FOR MORE INFORMATION

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on fitness for older adults was published in the July 12, 2006, issue; and one on psychiatric illness in older adults was published in the June 7, 2000, issue.

Sources: National Institute on Aging; American Geriatrics Society; National Council on Aging; Centers for Disease Control and Prevention

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.

TOPIC: AGING

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