Understanding Fragility
Fragility is not a disease, but rather a condition of the body that falls between being fully capable and completely incapacitated, and between being in good health and being ill. It is a significant and common health issue among the elderly, impacting both physical and mental health. Those in a state of fragility experience a decline in the physical capabilities of various body systems, aggravating illnesses, cognitive impairments, reduced mobility, including slower walking and balance issues that may lead to falls, and ultimately dependency.
Signs and Symptoms
If an elderly individual shows at least 3 of the following 5 signs, they are considered to be in a state of fragility:
- Unintentional weight loss of more than 4.5 kilograms, or more than 5% of body weight within a year (Weight Loss)
- Feeling tired and lacking energy (Exhaustion)
- Muscle weakness (Weakness)
- Slower walking speed (Low Walking Speed)
- Reduced physical activity (Low Physical Activity)
Impacts of Fragility
- Mental aspect: Cognitive impairment, depression, feelings of hopelessness, lack of energy
- Physical aspect: Increased risk of falls due to loss of walking and balancing abilities, muscle weakness, decreased functionality of various systems
- Economic aspect: Increased expenses due to the severity of various diseases, acute confusion due to illness, need for care, long-term care requirements, hospitalization, disability, and increased mortality rate
Prevention Before Becoming Fragile
Prevention and health promotion strategies to avoid becoming fragile include:
- Exercise: Both resistance training and aerobic exercise
- Strength training: Including resistance to weightlifting, large muscle group exercises to increase body muscle mass, strength, endurance, and walking speed
- Tai Chi: A slow and gentle form of exercise involving physical movement and meditation to improve balance and walking
- Dietary Supplements: Including supplemental protein between meals to help maintain muscle mass. This may also involve medications to increase appetite, and the use of the Mini Nutritional Exam for further nutritional assessment, as well as family meals
- Maintain oral health: Brush and floss at least twice a day, limit sugar intake like soda and sweets, and have at least one dental check-up per year
- Evaluate the home or living area environment: for safety to reduce the risk of falls, install grab bars in the bathroom, adjustable seated showers, countertops, wide doors, contrast colors of countertops, floors, walls, non-slip surfaces, ramps, adequate lighting, and emergency call systems
- Family awareness: Understanding the changes with fragility to provide proper care for the patient
