Frailty refers to the compromise to the ability to cope with day to day and acute stressors. The increase in vulnerability results from age-related declines in physiological reserve as well as function across the multiple organ systems. This can become a cascading issue, for instance, there is an increase risk of falls and fractures, which if happens, can affect confidence walking going forward. The lack of movement out of fear can cause muscular loss which further raises the risk of falls. Signs of frailty include unintentional loss of weight of greater than 5% of the previous year’s weight, slow walking speed of less than 1m/s, need for frequent rests, and signs of weakness like weak grip strength.
Physical frailty can be caused by decline in physiological functions, such as cardiac function. With age, cardiac muscles stiffen and there is also progressive stiffening of arteries. This can decrease the cardiac efficiency and output and lead to higher blood pressure, along with arteriosclerosis. There are also muscular changes, in particular sarcopenia. This sees the loss of muscle mass and strength, in part because of the slower rate of repair and replacement of muscles. This reduces the quality of muscle and its performance.
Lifestyle choices can also lead to frailty, in particular a sedentary lifestyle and nutritional choices such as inadequate protein intake. There are screenings available for frailty, such as the FRAIL 5 item scale, FRIED’s Frail Scale and Clinical Frailty Scale.