Frailty is loss of physiologic reserve, which makes people susceptible to disability due to minor stresses. Common features of frailty include weakness, slowed motor function, weight loss, muscle wasting (sarcopenia), exercise intolerance, frequent falls, immobility, incontinence, and frequent exacerbations of chronic diseases.
Exercise and a healthy diet (see table Nutritional Recommendations) are recommended for preventing or reducing frailty. Older people who engage in regular aerobic exercise (eg, walking, swimming, running) increase their life expectancy and have less functional decline than those who are sedentary. Mood and possibly cognitive function may also be improved. Weight training can help increase bone and muscle mass and reduce risk of falls and fractures. A healthy diet may prevent or reduce risk of many diseases that contribute to frailty, including breast and colon cancers, osteoporosis, obesity, and undernutrition; morbidity and mortality may also be reduced.
Nutritional Recommendations for Prevention of Frailty
Measure | Description | Rationale |
|---|---|---|
Mediterranean diet | Consumption of more fruit, vegetables, whole grains, and fewer ultraprocessed foods Substitution of healthful fats for less healthful fats:
Possibly replacing some of the meat with legumes and beans Less healthful fats such as foods high in saturated fat (eg, butter, cheese, beef, pork, poultry with the skin, some prepared foods such as crackers) | Decreases risk of cardiovascular disease |
Reduced sodium diet | Optimal level of intake unknown but some evidence to support reducing intake to 2.3 g a day | Lowers blood pressure in some people |
High calcium diet and calcium supplements | For older adults, 1200 mg a day (most American diets contain only 500–700 mg a day) | Helps maintain bone density and reduce risk of fractures |
Adequate intake of vitamins and minerals | Largely by eating fruits and vegetables and a healthful balanced diet For people with deficiencies: Consultation with their health care profession for supplementation advice. | May prevent various chronic diseases |
High-fiber diet | Best obtained by eating fruits, vegetables, and grains | May prevent colon cancer Has a beneficial effect on serum lipids |
Adequate protein intake when combined with exercise | Optimal level of protein intake unknown but some evidence to support intake of 1.0 to 1.2 g/kg a day | Combination can limit age-related decrease in muscle mass, strength, and function |
