Frailty is of a central focus in the geriatric age group. Simply put it is a clinical syndrome of dysregulation of energetics and multiple physiological systems in the body. There are basically two kinds of frailty, physical frailty which is just getting old with age and index frailty which is getting older along with having multiple comorbid conditions. Frailty leads to decreased muscle mass, slowed motor performance, worsened exercise tolerance, decreased physical activity and inadequate nutritional intake.

The criteria that is used to define frailty in older adults are unintentional weight loss of more than 10 pounds in the last year, feeling of exhaustion with any kind of work that the patient does, difficulty in walking 15 feet distance, very low level of activity and reduced grip strength.

Grip strength is an excellent way to determine the level of physical frailty in an older adult patient. Equally important is the gait speed also called the speed of walking.

Management strategies for frailty should include avoiding any modifiable precipitating causes like immobility, depressed mood, social isolation, to improve the clinical manifestations of frailty like low physical activity, low strength and exercise tolerance and to minimize the consequences of the vulnerability by paying direct attention to environmental risks, extending social support and fall prevention.

Resistance and strengthening exercise appears to be a key management approach for frailty and its prevention in older adults. resistance training alone or as part of a multi-context exercise program has been found to increase strength and function in older adults with fewer adverse health outcomes.

Anyone who would like to ask me a medical question relating to the health of older adults can email me at I hope to provide a helpful answer in a future issue of this newspaper.

Disclaimer : The information shared in this column is based on current practice guidelines but is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your healthcare provider with any questions regarding a medical condition.

Dr. Arvindselvan Mohanaselvan, M.D.

Dr. Arvindselvan Mohanaselvan, M.D., is a physician board certified in internal medicine, with a subspecialty in geriatrics. He currently works at Apex Medical Group as a primary care and geriatric medicine provider. Email questions for Paging the Doctor on Call to