In the past century the world has seen a significant increase in life expectancy rates. Currently 1 in 6 people are over the age of 60 in developed nations, and this number is expected to increase to 1 in 4 by the year 2050. However with more people living longer, there is greater concern for the frailty of our population and the burden this places on individuals, families, our healthcare system, economy, and society as a whole. For example, frail patients in the hospital comprise approximately 75% of all admissions and result in healthcare costs up to 6 times more than non-frail patients.
Both medical terms sarcopenia and osteoporosis help to define frailty. Sarcopenia refers to the loss of muscle mass, strength, and physical function, while osteoporosis is the loss of bone mass. Their result is decreased mobility, quality of life, and increased risk of falls, fractures, hospitalizations, and death. It is important to note that although some decline in muscle mass and strength is expected with age, frailty denotes a more drastic decline beyond expected levels. In the clinic, measures such as gait speed, grip strength, and the ability to rise from a chair can be used as guidelines for frailty, along with DXA scans for skeletal muscle and bone mass.
Luckily, the largest influences on frailty are physical exercise and protein intake, both modifiable risk factors. Studies show that moderate-to-vigorous intensity weight training (60-80% of 1 rep max) is best for improving muscle mass, strength, and physical function amongst older adults compared to light weights (<50% of 1 rep max). On a physiologic level, this is due to heavier weights increasing the amount of type II (fast twitch) muscle fibers which are used for strength and power, whereas the normal aging process results in more type 1 (slow twitch) fibers used for endurance. This is demonstrated by the prevalence of older adults who need help to rise out of a chair, but once they are up are able to walk. Standing from a chair requires type II muscle fibers for strength and power, whereas walking is more an endurance exercise recruiting type I muscle fibers. Progressive resistance training has been shown to not only be effective at reducing the risk of developing frailty, but also reversing it. Studies with patients as old as 96 years old have shown improvement in physical function and quality of life with regular resistance training.
If you or a loved one are experiencing decreased quality of life from frailty, or want to prevent it in the first place, come check out our Strength and Balance Class for Older Adults, offered Tuesdays at 10 AM. We will help you get stronger and reduce the risk of falls in a safe environment, no experience necessary.
References
Chen YC, Chen WC, Liu CW, et al. Is moderate resistance training adequate for older adults with sarcopenia? A systematic review and network meta-analysis of RCTs. European Review of Aging and Physical Activity: Official Journal of the European Group for Research into Elderly and Physical Activity. 2023;20(1):22. doi:https://doi.org/10.1186/s11556-023-00333-4
Doody P, Lord JM, Greig CA, Whittaker AC. Frailty: pathophysiology, theoretical and operational definition(s), impact, prevalence, management and prevention, in an increasingly economically developed and ageing world. Gerontology. 2022;69(8). doi:https://doi.org/10.1159/000528561
Sayer AA, Cruz-Jentoft A. Sarcopenia definition, diagnosis and treatment: consensus is growing. Age and Ageing. 2022;51(10). doi:https://doi.org/10.1093/ageing/afac220
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