Contrary to common perception, frailty and ageing are not interchangeable terms. Recent research sheds light on the distinct challenges posed by frailty, affecting a smaller percentage of seniors but carrying significant health implications. This comprehensive review, authored by gerontologists from Canada and Mexico, provides invaluable insights into understanding, preventing, and addressing frailty in older adults. Particularly, it focuses on those with advanced cardiovascular disease.
Understanding Frailty
Frailty, a condition affecting about 10% of community-dwelling seniors, denotes a heightened vulnerability to severe health complications. However, its prevalence escalates substantially among older adults with advanced cardiovascular ailments, reaching up to 60%. For these individuals, events like a heart attack or major surgery can trigger a cascade of adverse effects. This can lead to a state of deconditioning and frailty.
The Physiological Challenges
Frailty manifests in various physiological changes, notably affecting cardiovascular function. An individual’s maximum aerobic capacity, as measured by VO2 peak, often falls below critical thresholds associated with frailty. Consequently, even routine tasks like dressing can push them to their physical limits, highlighting the severity of their condition.
Strategies for Managing Frailty
Holistic Approach to Exercise
Exercise emerges as a cornerstone in managing frailty, offering holistic benefits across cardiovascular, musculoskeletal, and neurological systems. By engaging in tailored exercise routines, individuals can harness the regenerative power of activated muscles. This facilitates inflammation reduction, tissue regeneration, and cognitive enhancement.
Key Considerations Before Starting
Prior to embarking on an exercise regimen, it’s imperative to gather essential information, including medical guidance, contraindications, and medication details. Additionally, understanding the individual’s preferences, nutritional status, and social support network is crucial for designing a personalised intervention plan.
Practical Strategies for Exercise Implementation
Balancing Aerobic and Resistance Training
While aerobic exercise is pivotal, it should be approached cautiously, especially for individuals with compromised balance, strength, or cognition. Instead, the focus should initially be on a combination of resistance and balance training, gradually progressing from light to moderate intensity.
Tailoring Exercise Regimens
For frail individuals, single-joint exercises targeting specific muscle groups may offer a more manageable starting point. Emphasising smaller muscle groups through exercises like knee extensions and calf raises can improve functional strength and endurance, laying the foundation for broader physical gains.
Importance of Gait Patterns and Balance
Gait patterns serve as a vital indicator of an individual’s health status, with walking speed and postural control offering valuable insights. Balance training should encompass activities that mimic real-world gait patterns, promoting core stability and improving overall mobility.
Looking Ahead
Consistent exercise is akin to investing in one’s “health bank,” accruing long-term benefits that bolster resilience and facilitate recovery. By prioritising exercise as a proactive measure, individuals can enhance their healthspan, effectively mitigating the risk of frailty and age-related decline.
In conclusion, understanding the nuances of frailty and ageing is imperative for promoting better health outcomes among seniors, particularly those with cardiovascular conditions. By embracing evidence-based strategies and adopting a holistic approach to exercise, individuals can navigate the complexities of frailty with resilience and vitality. Let us embark on this journey towards improved health, one step at a time.
References:
Mauricio VG, Daniel R, Duque G. Exercise as a therapeutic tool in age-related frailty and cardiovascular disease: challenges and strategies. Can J Cardiol. 2024 Jan 10.
Kaminsky LA, Arena R, Myers J, Peterman JE, Bonikowske AR, Harber MP, et al. Updated Reference Standards for Cardiorespiratory Fitness Measured with Cardiopulmonary Exercise Testing: Data from the Fitness Registry and the Importance of Exercise National Database (FRIEND). Mayo Clin Proc. 2022 Feb;97(2):285–93.
Esposito F, Reese V, Shabetai R, Wagner PD, Richardson RS. Isolated quadriceps training increases maximal exercise capacity in chronic heart failure: the role of skeletal muscle convective and diffusive oxygen transport. J Am Coll Cardiol. 2011 Sep 20;58(13):1353–62.
Dommershuijsen LJ, Isik BM, Darweesh SKL, van der Geest JN, Ikram MK, Ikram MA. Unraveling the Association Between Gait and Mortality-One Step at a Time. J Gerontol A Biol Sci Med Sci. 2020 May 22;75(6):1184–90.
