Are you frail? Nearly half of older adults are at risk

A look at how experts define frailty, how it differs from normal ageing, what puts someone at risk of becoming frail and what to do about it

- Dana G. Smith

(Bianca Bagnarelli/The New York Times)

In the 1980s and '90s, doctors diagnosed frailty largely based on their intuition.

“We used to say, ‘You know it when you see it,” said Dr Peter Abadir, an associate professor of geriatric medicine and gerontology at the Johns Hopkins University School of Medicine. “Which is just a crude way of saying frail people look frail.”

Fortunately, the field has advanced since then, and there are more specific and objective methods to diagnose the condition. Here’s how experts define frailty, how it differs from normal ageing, what puts someone at risk of becoming frail and what to do about it.

Doctors generally define frailty as having more vulnerability and less resilience to health events. A person who is frail is more likely to fall, for instance, and the risk of being hospitalised, needing long-term follow-up care or dying as a result of that fall is higher than in someone who is not frail.

Frailty is also understood to go hand-in-hand with ageing, though not everyone who is old is frail. “You can think of frailty as rapid ageing, or more rapid aging than your peers,” said Dr Kenneth Rockwood, a professor of geriatric medicine at Dalhousie University in Canada.

Estimates vary, but according to one large 2020 review, globally, about 11 per cent of adults in their 50s qualified as frail, while 51 per cent of people 90 or older were frail. In the United States, frailty rates tended to be higher among women, Black and Hispanic Americans and people with low income, according to a 2015 study.