Don’t let aging steal your life! Unlock the health code of old age frailty

Author: Xu Yanan Beijing Xiaotangshan Hospital Tiantan Xiaotangshan Rehabilitation Center

Reviewer: Yu Qiuhong, Chief Physician, Beijing Tiantan Hospital, Capital Medical University

As the global population ages and the average human life expectancy increases, the elderly are experiencing health challenges related to aging. Frailty syndrome is one of the "big enemies". It is like an "energy thief" that slowly depletes the body's systems and organ reserves, causing the elderly to gradually lose the ability to live independently. However, unlike aging, frailty can be intervened and improved after early detection. This means that if we take the right measures in the early stages, frailty can be "turned around".

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1. Clinical manifestations of frailty syndrome

The manifestations of frailty syndrome vary, the most common ones are as follows:

(1) Physical weakness: The elderly gradually experience a significant decrease in muscle strength, often feel tired and weak, and have difficulty completing daily activities that they can easily handle, such as climbing stairs and lifting heavy objects. This is also one of the main reasons for slow movement and reduced ability to live.

(2) Cognitive decline: Excluding dementia caused by disease, the elderly feel that their memory has deteriorated and their thinking is not as sharp as before. This kind of cognitive decline is often accompanied by physical decline.

(3) Social and psychological decline: Due to the decline in physical function and cognitive ability, the elderly are often no longer willing to participate in social activities. They have fewer friends and less interests. As a result, they become anxious and depressed and gradually withdraw from society.

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2. How to identify frailty syndrome?

To determine whether the elderly have a tendency to frailty, doctors will use some professional tools to evaluate, such as the commonly used FRAIL scale. This "health questionnaire" mainly examines five aspects:

(1) Fatigue: Feeling tired most or all of the time in the past 4 weeks.

(2) Decreased endurance: It is difficult to climb one flight of stairs without resting, without any auxiliary tools or help from others.

(3) Decreased ability to move freely: It is difficult to walk 100 meters without any auxiliary tools or help from others.

(4) Whether there are multiple diseases: whether there are more than 5 of the following diseases, including hypertension, diabetes, acute heart attack, stroke, malignant tumors (excluding small skin cancers), congestive heart failure, asthma, arthritis, chronic lung disease, kidney disease, angina pectoris, etc.

(5) Weight loss: Weight loss ≥5% in one year or less.

If three or more of these five items are met, it is possible to be diagnosed with frailty syndrome; if only one or two items are met, it may be a "pre-frail state", that is, a "sub-healthy" stage. If you have the above symptoms, it is recommended to go to the hospital for professional examination as soon as possible.

3. How to fight frailty?

Exercise is a good remedy! Exercise is recognized as an important means to delay frailty and maintain health. It can not only improve bone health and physical function, enhance physical strength, and reduce the risk of falling, but also improve mental health and quality of life. The methods suitable for exercise rehabilitation for the elderly mainly include the following aspects:

(1) Aerobic exercise: There are relatively more choices for this type of exercise, such as brisk walking, jogging, swimming, Tai Chi, and even square dancing. If the elderly have difficulty moving, they can choose to sit on a chair and step or ride a bicycle. The exercise does not have to be too intense. You can stop and rest when you feel a little tired. Moderate exercise is most friendly to the elderly.

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(2) Resistance exercise: For older people who want to improve their strength or endurance, an elastic band is a convenient and practical tool. It is lightweight and can be used at any time. Exercise can be performed 2 to 3 times a week, with 2 to 4 sets each time and 8 to 12 repetitions per set. It is recommended to proceed step by step and not to go too aggressive at the beginning.

(3) Flexibility training: The elderly usually have poor flexibility, which affects their ability to carry out activities in daily life. Doing some stretching exercises every day, such as slow motion stretching and yoga, can significantly improve the body's flexibility, but be careful to keep the movements slow and controllable, and do not force yourself.

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(4) Balance exercise: Fall risk is one of the most common dangers for the elderly, and proper balance exercise can effectively prevent falls. Tai Chi, Ba Duan Jin, single-leg standing, standing yoga, etc. can be selected. Each time, 5 to 10 minutes, about 3 times a week can be practiced. It should be noted that when doing balance exercises, it is best to make sure there is something around to hold on to, such as a chair, wall, handrail, etc., or have family members accompany you to ensure safety.

Exercise is effective, but for the elderly, exercise safety is more important. Before exercising, it is recommended to consult professional medical staff to develop an individualized exercise plan according to the situation. Also pay attention to choosing a flat and non-slip sports venue, and wear comfortable clothes and shoes. In addition, it should be emphasized that warming up before exercise is equally important. It is like warming up a car before going out, which can effectively reduce sports injuries. Warm-up methods can be chosen such as slow walking, squatting or easy gymnastics, etc., for 5 to 10 minutes, until the body is slightly warm and the heartbeat starts to speed up slightly. Pay attention to replenishing water during exercise and observe whether you have any uncomfortable symptoms. If you feel uncomfortable, you should stop exercising immediately and seek help.

(5) Paying attention to the diet of the elderly can help prevent and improve frailty: The latest research shows that scientific and reasonable dietary conditioning can effectively prevent and slow down the occurrence and progression of frailty. Among them, dietary diversification plays an important role, which can provide comprehensive and balanced nutrition for the elderly and help maintain various functions of the body.

A diversified diet is not just about "eating a lot", but about consuming at least 12 different kinds of food every day to ensure comprehensive nutrition. Vegetables, fruits, grains and protein foods should be properly matched to avoid over-reliance on a single food. For example, a moderate amount of fish or beans can provide enough protein for the elderly to help maintain muscle strength, while fresh vegetables and fruits are rich in vitamins and minerals, which help strengthen the immune system and keep the body healthy.

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In general, although frailty syndrome affects the quality of life of the elderly and brings about a variety of complications, there are still many ways to reverse the early stages of frailty. In addition to the individualized exercise and nutritional intervention mentioned above, the latest guidelines also propose that hyperbaric oxygen intervention is a good way to improve cognitive decline in the elderly. Let us care for the elderly together, find the "health code" to deal with frailty in the elderly, and let the elderly continue to enjoy a life full of vitality and happiness.

References

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3.KOJIMA G, LILJAS AEM, ILIFFE S. Frailty syndrome: implications and challenges for health care policy[J]. Risk Manag Healthc Policy. 2019, 12:23-30.

4.ZHAO C, WANG Y, JIA X, et al. Associations of dietary diversity trajectories with frailty among Chinese older adults: a latent class trajectory analysis based on a CLHLS cohort[J]. Nutrients. 2024,16(10):1445.

5. Science and Technology Management and Evaluation Committee of the Chinese Rehabilitation Medicine Association, Rehabilitation Branch of the Chinese Anti-Aging Promotion Association, Rehabilitation Assessment Group of the Physical Medicine and Rehabilitation Branch of the Chinese Medical Association, etc. Chinese Expert Consensus on Rehabilitation for Cognitive Frailty 2023[J]. Chinese Medical Journal, 2023, 58(9):949-953.