Frailty is a state in which the body becomes less resilient, meaning even minor health problems have a much greater impact than they once did, according to NHS GP Dr Azeem Majeed.
Dr Majeed, writing in the Daily Express, notes that two people aged 80 can have very different lives: one may still travel, garden and enjoy long walks, while another struggles with stairs or shopping. A minor illness that one person shrugs off in days can leave another needing weeks of recovery.
What is frailty and why does it develop?
Frailty develops gradually over many years through changes throughout the body, including loss of muscle strength, reduced bone density and a decline in the ability of organs to cope with physical stress. It usually results from a combination of factors: ageing leads to loss of muscle mass and strength, and long-term conditions such as diabetes, heart disease or arthritis can accelerate this decline.
Poor nutrition, physical inactivity, smoking and social factors like loneliness and isolation also increase the risk. Frailty is most common in older age but also affects younger adults with multiple long-term conditions, severe disabilities, or illnesses that reduce muscle strength.
How doctors identify frailty
General practitioners routinely look for signs of frailty in older patients. Increasingly, NHS computer systems use information already in medical records to help identify people who may be living with mild, moderate or severe frailty. However, no computer score tells the whole story; frailty is best identified through a combination of medical information and clinical judgement, considering how well someone manages everyday activities, mobility, memory, nutrition and overall health.
Can frailty be prevented?
Frailty can be delayed or slowed. Regular physical activity is the single most effective measure, particularly exercises that build muscle strength and improve balance. Walking is excellent, but resistance training or climbing stairs also improve strength and reduce the risk of falls.
Eating a healthy, balanced diet is also important, with adequate protein intake to maintain muscle mass and a varied diet rich in fruit, vegetables and whole grains. Avoiding smoking, limiting alcohol and maintaining a healthy weight contribute to healthier ageing, as do keeping long-term conditions well controlled and attending routine health checks. Spending time with family and friends, joining community groups, volunteering or taking part in local activities can support physical and mental wellbeing.
What if someone is already frail?
Many people living with frailty can improve their strength, confidence and quality of life with the right support. Exercise remains beneficial even for those already frail. Doctors may review medications to reduce side effects or stop medicines no longer needed. Good nutrition becomes even more important, and some people benefit from a dietitian's advice or treatment for conditions like osteoporosis. Falls prevention is another key part of care, including checking vision and hearing, reviewing footwear, making homes safer and encouraging appropriate physical activity.
Helping people remain healthy and independent is increasingly important. Frailty is a major challenge but not an unavoidable consequence of ageing. Many steps that reduce the risk of frailty also improve health generally. While we cannot stop the ageing process, we can influence how well we age by adopting healthy habits throughout life and recognising frailty early.
