Southwest Florida's Health and Wellness Magazine Health and Wellness Articles
By Andre Davies, M.D., Board Certified in Internal Medicine & Geriatrics
What makes older adults more susceptible to various health stressors and how can older adults prevent a decline in their own health?
Over the last few years, we have seen how devastating illnesses, like COVID, have impacted older adults in comparison to the younger generations. This vulnerability may be due in part to older adults having more complex medical histories than other age groups, which places them at higher risk. (Older adults with COPD, for instance, may have more health complications from a respiratory illness than a younger adult who has no history of lung disease). A second contributor to this vulnerability is ‘frailty,’ which is an age-related syndrome, not necessarily associated with any specific medical illness.
About 1 in 10 adults 65 years and older are considered to have frailty, and that increases to 1 in 4 adults 85 years and older. Frailty affects a person’s physiologic ‘reserve’ and ‘resilience,’ or the ability of the body to recover from a health stressor. Being frail is associated with increased falls, hospitalizations, poorer outcomes from surgeries, delayed recovery, and increased risks of mortality. It is therefore important that physicians identify patients who are frail or are at risk so that we may provide guidance to patients and other health professionals to reduce the incidence of those adverse events.
Frailty is a challenging topic to discuss, in part because there are several ways to define this syndrome. It is broad, covering concepts that range from physical manifestations to changes at the cellular level. In general, the body of a healthy person exists in a balance, where the various systems work harmoniously together. In frailty, these various systems are dysregulated and negatively impact each other. For example, the loss of muscle in the body negatively impacts our body’s metabolic system, changing the way our bodies process insulin, then affecting our stress responses and increasing inflammation chronically. This in turn affects the musculoskeletal system. This dysregulation decreases our body’s ability to respond to crises like illness.
There are many ways to measure frailty and make a diagnosis. A basic and easy to understand approach is looking to see if the patient has a frailty phenotype, also known as physical frailty. I evaluate my patients for clinical manifestations of frailty: signs of weakness, significant weight loss, fatigue, decreased walking speed, and changes in level of physical activity. Meeting three out of five of those criteria suggests that the patient is frail; two out of the five qualifies as pre-frail.
Research into frailty syndrome is a hot topic in the science of the aging community, and the goal of these investigators is to identify therapies to address it. The results have been frustrating. Even though inflammation levels are elevated, and certain hormones may be lower, efforts to use targeted therapies like anti-inflammatories or hormonal replacements have not shown significant success. One idea why these therapies do not work is that frailty affects many systems throughout the body, and fixing one area does not heal the larger problem. There is no easy fix or reversal of frailty. However, patients can take steps to reduce their risk of becoming frail.
One of the most important changes a patient can make to combat frailty is to increase their physical activity. Increased physical activity helps the body stave off muscle atrophy, increase energy levels, reduce the risk of insulin resistance, reduce cardiovascular disease, promote healthy metabolism, and reduce hormonal surges that increase inflammation. Physical activity is a cornerstone of healthy aging; the addition of social interactions amplifies its impact. Whether you are participating in group exercise classes, sports or even an outdoor walk with friends, you not only reap the benefits of physical fitness, but studies show you also benefit from social connections and improved well-being.
I recommend patients adhere to a healthy nutrition plan, like the Mediterranean diet, as a means of improving their overall well-being and reducing the risk of chronic diseases. One of the benefits of the mediterranean diet is that it promotes the consumption of lean proteins which provides the body with essential amino acids necessary for muscle growth and repair. Adequate protein intake provides rich nutrients to your muscles that thrive during physical activity, and therefore improves the overall system.
I advise patients at risk of frailty to consume 0.8 grams of protein for every 1 kg of body weight, depending on their health issues. For example, a 150lb adult would consume 54grams of protein daily. Of course, it is important to check with your healthcare provider to review your medical history, before starting any nutritional plan. As part of this conversation, patients should review their current medications with their provider. There may be some prescriptions that are no longer indicated or others that could be consolidated.
By focusing on prevention, early detection, medication management, comprehensive care, and promoting a good quality of life, providers can help patients maintain optimal health. Through this collaborative and pro-active approach, together we can improve our well-being and prevent becoming frail.
To learn more about our Concierge Internal Medicine services and Dr. Andre Davies, please visit our website at GCMedicine.com. If you would like to schedule a complimentary meet and greet with Dr. Andre Davies, please email Christina@gcmedicine.com or contact our office at 239-566-3100.
Andre Davies, MD
Dr. Andre Davies is a highly qualified Ivy League trained board-certified physician in both Internal Medicine and Geriatrics. He brings a wealth of expertise and knowledge to his practice. Specializing in adult primary care for both men and women, he focuses on preventive health, managing chronic conditions such as high blood pressure, cholesterol, and diabetes. Dr. Davies excels in pre-op exams, annual physical, diabetic screenings, immunizations, cancer screenings, weight management, and nutritional deficiencies. As a fellowship trained Geriatrician, he adeptly addresses complex health issues, emphasizing cognitive evaluations and mental well-being.
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