Indicators of Frailty Start to Appear Early, Probably Due to Lifestyle Choices

Clinicians classify frailty in a symptomatic way, looking at factors such as weight loss, weakness, walking speed, and so forth. This is a method of assessment designed for use with elderly people, but researchers here apply it to a study population that includes people in the 40-60 age range. They find that in this range, a fair number of individuals exhibit signs of what in the elderly would be called prefrailty - meaning just a few symptoms are present, rather than a majority. One logical possibility is that this is a manifestation of a sedentary, increasingly overweight population. Physical activity and good dietary choices (largely eating fewer calories) are required to minimize declines in capacity as time marches on. It requires greater neglect to be truly out of shape at age 40 as compared to age 60, but it is certainly possible to achieve.

This study reports on pre-frailty in 656 presumed healthy, independently living community-dwellers aged 40 to 75 years. We used an established frailty phenotype with two objective components (grip strength, walking speed) and three self-report measures (unintentional weight loss, physical activity, exhaustion). This phenotype was developed on people aged 65+ years and has been reported to sensitively identify pre-frailty and frailty states in this population. Our research indicates that using this frailty phenotype, pre-frailty is detectable in younger community dwellers aged 40-75 years. Moreover, neither age nor gender was significantly associated with any frailty state.

Our frailty rates (1.8% frail, 39% pre-frail, and 59.2% not frail) are comparable with those published recently from analysis of data from a large UK biobank, reporting on 493,737 people aged 37-73 years (3% frail, 38% pre-frail, and 59% not frail).

Setting unintentional weight loss aside (which requires medical investigation), our findings suggest that there are many people aged 40 years or older whose frailty status could potentially be addressed by increasing physical activity, building muscle, improving exercise tolerance, nutrition and mental health. It is reasonable to propose that chronic disease self-management and population health interventions to improve physical activity, such as workplace or community wellbeing programs, could significantly attenuate reverse or slow the onset of pre-frailty in community dwellers aged 40 years or more, and their subsequent risk of progression to frailty.