Preventing Frailty – Of All Kinds

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by Nils Osmar. August 11, 2022. Medical Disclaimer. Image by Gerd Altmann from Pixabay

To me one of the tests of whether anti-aging interventions are working is whether or not we find ourselves drifting into frailty.

This is much on my mind because I was born in 1952 (back when Harry S. Truman was President!) and will be turning seventy this coming December. In one sense, seventy is just a number. But in another, we seem to turn a corner in our seventh decade in a way that makes frailty more likely.

Age-related frailty is obviously intertwined with the aging process. If researchers succeed at curing aging, we should be able to do away with frailty entirely at some point. But till aging is reversed or cured, we need to view the drift toward frailty as a reality and figure out ways to deal with it.

This study clarifies that frailty has physical, mental, social and psychological elements. It also clarifies, though, that not everyone becomes frail:

From the study:

(Emphases are mine)

Approximately a quarter of individuals aged > 85 years are living with frailty and as such the identification of those who are frail is a public health priority…

Biological risk factors for the development of the frailty syndrome include age-related inflammatory processes, as well as common chronic diseases and their interactions with the environment. These factors lead to a physiological decline across multiple body systems, including skeletal muscle and bone, the cardiorespiratory system and the immune and endocrine systems….

Cognitive frailty refers to cognitive decline in absence of dementia… social frailty refers to loneliness and the lack of robust social networks… psychological frailty refers to the psychological traits in an individual that may predispose them to a stressor event (e.g. a recent bereavement, low mood or a lack of motivation)

The accelerated loss of physiological reserves which characterizes frailty can lead to wide range of common healthcare problems, such as a loss of strength, a reduction in mobility and subsequent falls, a reduced appetite and undernutrition, incontinence, sensory decline, and depression and anxiety.

As can be seen, encouraging regular exercise can promote healthy ageing and reduce the long-term health sequelae of frailty, thereby reducing its impact on healthcare systems. This has been supported by numerous studies positively associating regular exercise with reduced falls risk and improved balance, mobility, muscle strength and a reduction markers of frailty…

My experience with frailty

The study makes it clear that there’s much to think about if our goal is to prevent frailty and stay healthy as long as we’re around.

Physical frailty is important, but is part of a larger picture which includes the loss of our social support systems as time goes by. Even if we’re slowing or preventing the decline into frailty in ourselves, the aging process will still be going on in the communities around us, robbing us of friends and family members as time goes by, leading to frailty of a different sort. (In my own case,

Losing friends is part of aging – whether or not we’re aging ourselves

I’ve lost seven friends in the past two years. All of them were around my age; some a few years older or younger. “Aging” wasn’t technically the cause of death, but it was an underlying factor.

  • One friend, in his mid-70s, seemed to be the picture of health; he was vital and active and happyp; but started having health issues and was diagnosed with three types of cancer. He still seemed to be doing well, but then had a stroke, after which he was moved nursing home to recuperate, caught Covid in the nursing home, and died.
  • Another friend, in her late 60s, was suffering from numerous age-related health problems, including joint pains and arthritis, which were limiting her mobility. She lost her job due to the Covid shut down, became depressed due to being isolated and home-bound, and took her own life.
  • A third friend, in his early 60s (he seemed so young!), was still active in his field of work, but needed needed an organ transplant because his kidneys were failing. He was set to get one, but died on the operating table, a danger which increases as we get older.
  • A fourth friend, who was two years older than me, appeared healthy, then was diagnosed with multiple melanoma. He was told he might have five years to live. He went on a low-nutrient vegan diet to try to cure it; and was dead three months later.
  • A fifth, a dear friend from high school, had been in and out of hospitals for decades due to morbid obesity, diabetes, and heart issues. She joked that she almost lived at the hospital,. She died at the age of 69 during surgery which was trying to repair her heart condition.
  • A sixth friend, in her late 60s, who was also morbidly obese, died of obesity-related complications.
  • A seventh, in his early 60s, who was having numerous health problems related to substance abuse and addictions, but was also feeling discouraged because of difficulty finding work at his age, committed suicide.

These losses were sad and jarring, but, sadly, they weren’t unusual for people in my age group. My parents experienced similar problems when they were around my age; every week seemed to bring more news about a friend or family member dying.

I don’t have easy answers to the problem of social frailty related to folks we’re close to dying, but I’m aware of it as a problem that needs to be solved. It’s a reminder that “fixing aging” in ourselves is a start, but “fixing aging” in the world is also important.

Physical frailty and exercise

Re: preventing physical frailty, exercise is key. In my own case, I found myself drifting into sarcopenia about three years ago. I had been taking anti-aging supplements for about a year. I had begun doing HIIT (running and stair-running), and getting exercise by walking. They were helping on one level, ut I was still going downhill physically, visibly losing muscle as the years went by.

I started taking NMN and other anti-aging supplements. They helped somewhat, but weren’t saving me from muscle wasting and sarcopenia.

I was able to reverse the drift into sarcopenia with better nutrition (eating more high quality protein), taking supplements that increased my testosterone levels, and adding resistance training. See article. Some people told me I “looked younger” and healthier; I did like hearing this, what was more important to me was that I wasn’t continuing to slide rapidly downhill.

Resistance training clearly matters, but HIIT and aerobics clearly matter too. One of my goals for the coming year is to add both more consistently back into my regimen.

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