What is this condition
With age, muscle mass and strength gradually decrease, metabolic processes slow down, and the capacity of the heart, lungs and kidneys decreases. As long as the reserve is sufficient, a person copes with the load. With fragility, the reserve is exhausted: any small event - a cold, a new drug, moving, forced bed rest - knocks you out of balance and starts a chain of complications. Separately, sarcopenia is distinguished, that is, loss of muscle mass: it is this that largely determines weakness, unsteadiness and the risk of falls.
- Depletion of body reserves
- Loss of muscle mass and strength
- Poor tolerance to any stress
- High risk of falls and fractures
- Long recovery after illness
- Risk of loss of independence
Signs by which they recognize
Several simple indicators are assessed, and the presence of three or more indicates fragility. These include unintentional weight loss, a constant feeling of fatigue and exhaustion, muscle weakness noticeable by the strength of the handshake, slower walking and low physical activity. In everyday life it looks like this: a person begins to cross the road longer, holds on to furniture, refuses walks and meetings, eats little and without interest, and stops leaving the house. Memory loss, depression and sleep disturbances are often associated.
- Unintentional weight loss
- Constant fatigue and exhaustion
- Weakness, difficulty opening a jar or getting up from a chair
- Slowing down gait
- Decreased physical activity
- Refusal to walk and socialize
- Decreased memory and mood
What accelerates the development of fragility
The main accelerator is immobility: even a week of bed rest noticeably reduces muscle strength in an elderly person, and it takes months to restore it. A diet lacking in protein is strongly affected, as are problems with teeth and swallowing. A separate and very common reason is taking many medications, which often include sleeping pills, strong painkillers and drugs that cause dizziness. Loneliness, depression, deterioration of hearing and vision close the circle, depriving a person of activity and communication.
- Prolonged bed rest and inactivity
- Lack of protein in the diet
- Taking multiple medications at the same time
- Deterioration of vision and hearing
- Depression and loneliness
- Chronic pain
- Poor dental condition
- Vitamin D deficiency and anemia
Assessment and examination
There are simple tools that are used at the appointment: measuring walking speed over a short distance, a chair rise test, assessing hand strength, short questionnaires about falls, weight and fatigue. At the same time, they are looking for removable causes of weakness: anemia, vitamin D and B12 deficiency, thyroid disorders, protein deficiency, diabetes, heart and kidney failure. An obligatory part is an analysis of all medications taken and an assessment of memory, mood and home safety.
- Walking speed and chair rise test
- Hand strength assessment
- Complete blood count and ferritin
- Vitamin D, vitamin B12
- TSH, glucose, albumin, creatinine
- Complete review of the drug list
- Assessment of memory, mood and vision
- Inspect your home for the risk of falls
What really helps
The greatest proven benefits come from regular resistance and balance exercises: they increase muscle strength and reduce the risk of falls, even in very old people. The second most important factor is a sufficient amount of protein in each meal and the total caloric content of the diet. The third is to review medications with your doctor and discontinue those that are no longer needed or cause dizziness. Additionally, treatment of deficits, correction of vision and hearing, safe home improvement, and maintaining communication are important.
- Strength exercises 2-3 times a week
- Balance training and walking
- Protein in every meal
- Adequate drinking and calorie intake
- Review of medications with a doctor
- Vitamin D replenishment and anemia treatment
- Glasses, hearing aid, dental treatment
- Handrails, non-slip mats, good lighting
- Communication, feasible activities and walks
