Frailty — the feeling of being weak, fragile, and having low energy — tends to worsen over time, but past research has shown that about nine to 14 percent of already frail older adults actually become stronger and less frail as they age.
In a new study on men, researchers set out to investigate why this is so. Specifically, what factors might predict whether frailty will worsen or improve over time?
Their findings, published in the Journal of the American Geriatrics Society, reveal that having stronger leg power, being married, and reporting good or excellent health were linked to improvements in frailty status.
For the study, the researchers analyzed data collected from more than 5,000 men aged 65 or older (average age was about 73) who had volunteered for a study about bone fractures caused by osteoporosis, a condition characterized by thinning of the bones, a loss of bone density or increasingly fragile bones.
At the study’s onset, between 2000 and 2002, the men all lived independently and could walk; none had had hip replacements. Most of the men participated in a second examination about four years after the study began.
In the beginning, the researchers rated the participants’ frailty status by measuring levels of weakness, exhaustion, lean muscle mass, walking speed, and physical activity. They also asked the participants to fill out a questionnaire about their race, ethnicity, education, marital status, tobacco and alcohol use, and any diseases they had, as well as how they would self-rate their health.
The men were categorized as frail, pre-frail (had one or more signs of frailty, such as low grip strength, low energy, slow walking speed, low activity level or unintentional weight loss), or robust (showing no signs of frailty).
The researchers tested the men on their ability to think and make decisions. They also assessed their ability to perform daily tasks such as eating, bathing, and performing other necessary activities. A group of 950 participants took blood tests to look for signs of inflammation.
At the start of the study, nearly eight percent of the men were frail and 46 percent were pre-frail. The most common problems for the frail men were weakness, slowness, and low activity. Over four and a half years, the number of frail men increased while the proportion of robust men decreased. Among the men who were frail at both visits:
- 56 percent had no change in frailty status;
- 35 percent had become frailer or had died;
- 15 percent of pre-frail or frail men improved.
Having greater leg power, being married, and reporting good or excellent health were linked to improvements in frailty status. In fact, married men were 3.6 times more likely to improve their frailty status.
Participants who had trouble performing their daily activities, as well as those with diabetes or chronic obstructive pulmonary disease (COPD), were less likely to improve their frailty level.
The findings suggest that engaging in activities that preserve strength and target leg muscles, preventing chronic conditions like diabetes and COPD, and improving social support might be good ways to lessen frailty and slow its progression.
Source: American Geriatrics Society