Loss of muscle mass begins early. We loseas much as 3% to 5% of muscle mass each decade after age 30. Frailty is the top reason seniors seek medical care.
Did you know that U.S. seniors use more of all the health-care related spending than any over demographic–about 34%. Yet we only make up about 15% of the population here. Frailty is the #1 reason seniors seek medical care.
But what is frailty? This is part 1 of a two-part post. In the first part we’ll look at the definition of frailty, how it affects us as we age, and one important symptom. In part 2 we’ll focus on how it is diagnosed.
What Frailty Means to the General Public
To most of us, frailty simply means a person who is weakening, who is less able to take care of their own needs. The dictionary agrees and simply says that frailty is a condition of being weak and delicate.
In reality, though, frailty begins much earlier than our senior years; and the medical community has a much more extensive and complex definition.
What Frailty Means to the Medical Community
According to the Review Annales de Gerontologie, Authors Jean-Pierre Michel. Pierre-Olivier Lang, and Dina Zekry say that “Frailty is an extended process of increasing vulnerability, predisposing [one] to functional decline and ultimately leading to death. Different presentations of frailty are encountered by the clinician, as a result of the combination of factors such (as) age, gender, lifestyle, socio-economic background, co-morbidities, and affective, cognitive or sensory impairments.“
In other words, frailty is a condition, a medical syndrome, or a group of symptoms that collectively characterize it as a disease. It is also important to understand that some elderly never get frail.
How Does Frailty Affect Old Age
Frailty appears as an age-related physical vulnerability resulting from an impaired homeostatic reserve. Homeostatic here means the tendency of the body to maintain stablility as it compensates for changes such as diaseases, broken bones, etc. This word (homeostasis) will be used repeatedly throughout this post.
The body is a marvelous machine, always repairing itself; but as our body becomes less able to withstand stress, it becomes unstable leading to a higher risk of frailty-related complications such as falls, functional decline, multiple medications, an increased risk of hospitalization, cross infection, institutionalization, and eventually death.
One is pre-frail when one has physiological reserves sufficient to respond adequately to acute diseases, injury, or stress. In this case, the patient recovers completely.
One is frail, though, when one has incomplete recovery after any new acute disease, injury, or stress. I have recurring back problems and using this definition I wonder if I could be diagnosed as some degree of frail?
What my Doctor Prescribed
My doctor suggested that I was losing too much muscle mass. He prescribed drinking a protein shake immediately after any type of exercise as well as lifting weights. He was especially concerned about my legs. You can read more about him here.
I paid attention to the problem but decided that more walking would do the trick. I also ditched the protein powder. I was wrong. After three months he measured and I came up far short.
Dr. Emhof wanted to see me again in another three months to measure my progress. Each time he used a body composition monitor to measure muscle mass throughout my body.
So in three months I was back and had made only a little progress. He stressed weight training again– five reps of 15 or more—about a 15-minute workout at least two times a week. Begrudgingly, I joined a gym for the first time in twenty years.
What Leads to Loss of Muscle Mass
Loss of muscle mass begins early. As we engage in lesser activities, this leads to a loss of as much as 3% to 5% of muscle mass each decade after age 30. This lessens our strength and mobility.
Remember the term homeostasis? Well our body’s damage repair processes start out really good but as time goes by the damages accumulate. The repair process wanes. As a lot of things go wrong, everything begins to double and the body cannot repair itself.
According to medical science, our muscles grow and strengthen until about age 30, but then the process reverses itself. We begin to lose muscle mass and function, losing some muscle mass even if we remain active.
What does Loss of Muscle Mass Lead to
The medical term for this is sarcopenia, and this process typically happens faster around the age of 75, though it can begin as early as 65. Loss of muscle mass is a characteristic of frailty.
Also around the age of 75, a person’s overall health can spiral downward leading to weakness and loss of stamina. Physical inactivity increases and muscle mass declines faster. This is most prevalent in those of us who are inactive, but it can affect active adults too.
This causes other symptoms, such as a reduction of the nerve cells that normally send signals to our brain to begin movement. There can also be a decrease in hormones, such as testosterone. Loss of muscle mass can lead to a body’s inability to turn protein into energy, and even more important an inability to get enough protein and calories a day to build body mass. We notice this when an individual stops eating and begins to lose weight.
In the next segment of this post we’ll talk more about muscle mass, what to look for, and how to reverse its loss. We will also talk about how doctor’s measure frailty.
Do you worry about being frail and losing your strength and balance as you get older? Is the loss of muscle mass something that is affecting you in your 60s? Please share your observations in the comments below.