From the Guidelines
Recent studies in frailty emphasize the importance of multicomponent interventions, including physical exercise, nutritional support, and cognitive stimulation, to prevent functional decline and maintain independence in older adults. The most recent and highest quality study, published in 2023 in the journal Ageing Research Reviews 1, highlights the effectiveness of exercise programs, particularly resistance training, in improving physical outcomes and quality of life in older adults with frailty.
Key components of effective interventions include:
- Resistance training 2-3 times weekly to improve physical functioning and reduce frailty
- Nutritional support with protein intake of 1.2-1.5g/kg/day to promote muscle mass and strength
- Cognitive stimulation to maintain cognitive function and prevent decline
- Technology-based interventions, such as wearable devices and telehealth, to monitor and manage frailty remotely
Emerging research areas include:
- The role of inflammation in frailty and the potential benefits of anti-inflammatory medications
- The influence of the gut microbiome on frailty and the potential benefits of probiotics or other microbiome-targeted interventions
- The development of novel biomarkers for frailty, including skin autofluorescence, salivary α-amylase, and genetic features of frailty
- The use of artificial intelligence and machine learning to identify individuals with frailty and predict outcomes
Overall, the field of frailty research is moving towards recognizing frailty as a medical condition requiring proactive management, rather than an inevitable consequence of aging, with a focus on early identification and intervention to prevent functional decline and maintain independence 1.
From the Research
Latest Studies on Frailty
- Frailty is a clinical syndrome with a worldwide prevalence of 5-27% among those aged over 65 years, characterized by loss of muscle strength and impaired physical function 2.
- Nutritional deficiencies and low physical activity are common in this age group and have a significant role to play in the onset and progression of frailty 2.
- Vitamin D supplementation using 4000 IU/daily is safe and has a modest beneficial effect on physical performance for frail individuals and those with insufficient vitamin D levels 3.
- Management of frailty requires effective strategies for the delivery of care that range across the continuum of frailty severity, including frailty screening, case identification, and management of frailty 4.
Interventions for Frailty
- Exercise, testosterone, vitamin D, calcium, and protein supplements have been shown to improve health among older men with low-normal to low testosterone and mobility problems 5.
- A combination of progressive resistance training, testosterone undecanoate injections, and oral supplements of vitamin D, calcium, and protein improved 30-s chair stand test performance, muscle strength, and quality of life in older men 5.
- Evidence-based interventions for the prevention and management of frailty include frailty screening, exercise intervention, nutrition intervention, multi-domain intervention, drug administration, social support, and health education 6.
Key Findings
- Frailty is preventable and reversible, and several interventions have been carried out to offset and reverse the condition 2.
- Vitamin D insufficiency (≤ 75 nmol/L) is associated with greater benefits from vitamin D supplementation 3.
- Individually tailored interventions that preserve an individual's independence, physical function, and cognition are essential for managing frailty 4.
- A summary of the best evidence for prevention and management of frailty provides guidance for clinical or community medical staff to develop and apply frailty intervention and practice programs for older people 6.