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Lack of activity can lead to a downward spiral of poor health resulting in frailty, a condition that threatens the mind, body and social life of older adults, according to senior care experts.
“We regularly see seniors who are literally trapped in their homes because they are too weak to perform many of the activities they need to remain safe and independent, or to even enjoy life,” said Bob Vielee, owner of the Home Instead Senior Care office serving Lackawanna, Monroe, Pike, Wayne, and Wyoming counties. “That’s why staying active is viewed by so many as vital to healthy aging. Differences in perceptions between family caregivers and seniors can make addressing these issues challenging for many families.”
This problem is what prompted Home Instead Senior Care to develop the Get Mom Moving Activity Cards and Web site at www.getmommoving.com, both designed to help keep seniors engaged and fit. These resources provide the tools by which seniors can fight frailty.
A recent national survey conducted for the Home Instead Senior Care® network found that 74 percent of seniors 65 and older say that staying physically active is a major challenge. Adult caregivers see the problem as well: 81 percent of adult caregivers listed staying physically active as a top challenge for seniors. That challenge leads to another worry: 90 percent of seniors in the survey say their greatest fear is loss of independence.
Frailty can be difficult to define, but most know it when they see it, said Stephanie Studenski, M.D., M.P.H., one of the nation’s foremost authorities and researchers of mobility, balance disorders and falls in older adults, and director of clinical research for the University of Pittsburgh Institute on Aging. Medical professionals describe frailty as a syndrome of weakness, fatigue and decline in physical activity that may be triggered by hormonal or inflammatory changes or chronic disease states. For some, frailty results from a heart attack or stroke, while another senior might experience falls and weight loss.
Studenski and her colleagues conducted a series of focus groups with health care providers and family caregivers about how they perceive frailty in an effort to better identify the condition. “I think the thing that was most striking to me was that many family members we talked with perceived that an older person is getting more or less frail based more on social and psychological factors rather than physical factors. Doctors, on the other hand, focused on the physical manifestations in an older adult,” she noted.
Dr. Studenski said that frailty can be both prevented and reversed by activity. “One of the core ideas in aging is that there are underlying problems in the body’s self-correcting mechanism. For example, when a young person is bleeding, the body self-corrects by increasing the heart rate. But older adults, because of medication or health problems, may have lost the ability to self-correct by being able to increase their heart rate. Through activity, though, seniors can build both physical and mental reserves that can help their bodies better tolerate problems that come with aging.”
So, in a very real way, family caregivers who can encourage and integrate physical, mental and social activities in seniors’ lives are helping them ward off frailty and stay healthy. And that addresses seniors’ biggest fear of losing their independence as well. “This topic is at the heart of the concerns that we see each day in the lives of seniors and those who care for them,” said Home Instead Senior Care’s Vielee. “Fear of frailty keeps seniors worried about whether they can stay home.”
Look and See Signs of Frailty
In a women’s study released last summer, researchers at Columbia and Johns Hopkins Universities discovered the important role activity plays in the fight against frailty and shed new light on what causes the condition.
Linda P. Fried, M.D., MPH, and scientists found that frailty is the result of a systems failure in older adults, rather than a specific problem, disease or even chronological age. Data from women ages 70-79 led researchers to discover that half of those frail had three or more systems at abnormal levels, compared with 25 percent of the pre-frail and 16 percent of the non-frail population. Among the physiological factors that were assessed included anemia, inflammation and fine motor skills.
Solutions to address frailty including medications and hormone replacement are unlikely to prevent frailty unless they are designed to improve multiple systems, Dr. Fried noted. “This may explain the importance of approaches such as remaining physically active as we get older, since activity improves many aspects of biology and overall health.”
So how do family caregivers know what to look for? Following, from Stephanie Studenski, M.D., M.P.H., University of Pittsburgh geriatrician and researcher, and Home Instead Senior Care, are the signs that a senior might be becoming frail:
- Change. If a senior has always been interested in talking to the neighbors, reading the newspaper or volunteering and is withdrawing from those interests, suggest your loved one see a doctor.
- Inactivity. If your senior suddenly becomes less active, investigate what could be the cause.
- Slowing down. If grandpa always used to have a bounce in his step and now, suddenly, trudges along, that’s a bad sign.
- Loss of appetite and weight. A senior who always had a healthy appetite and doesn’t any more should be of concern to their loved ones.
- Unsteadiness. Loss of balance comes with aging but an increasing unsteadiness is a sign that something could be wrong.
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