As Problems Accumulate, Frailty May Set In

Jan. 1 -- THURSDAY, Dec. 31 (HealthDay News) -- "Frail" and "elderly" don't always have to go together, say experts who have begun to shine a brighter light on the condition of frailty in older adults.

Among people older than 65, up to 10 percent are frail -- a percentage that rises with age, according to a leading researcher in the field, Dr. Linda P. Fried, dean and DeLamar professor of public health at Columbia University's Mailman School of Public Health in New York City.

Most people know frailty when they see a fragile elder, Fried said.

"If you ask people if they have ever known anyone who is frail, everyone holds up their hand," she said. "They perceive [the frail person] as thin, weak, slow and as fragile."

But Fried and other experts have a more scholarly definition of frailty. They see it as a constellation of signs and symptoms involving many bodily systems, all slowing down or shutting down. Typically that means weight loss, loss of muscle strength, perhaps cognitive decline and problems in other bodily systems. A frail person might have inflammation, anemia, too much body fat and problems with fine motor skills, for instance.

"I would define frailty as the loss of reserves in multiple systems, including physical and mental health as well as social supports," said Dr. Claire Heppenstall, a clinical research fellow with the University of Otago in New Zealand. She has received funding from the Health Research Council of New Zealand to study fragile elders.

To Dr. Sharon A. Brangman, president-elect of the American Geriatric Society, the cumulative effect of problems is what leads to the frailty.

"It doesn't look like it is related to any one organ system or problem but a conglomeration of dysfunction in many different organ systems, which results in a person having much less physiological reserve to recover from stressors, whether internal or external," said Brangman, a professor of medicine and chief of geriatrics at the State University of New York's Upstate Medical University in Syracuse.