Frailty

Frailty is an umbrella term for a set of conditions that can be changed: weight loss, slowness, weakness, sedentary living and fatigue.^{1Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 431.} It is not a chronic disease, but it both worsens and is worsened by underlying disease.^{1Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 431.} The FRAIL Scale is a questionnaire that measures a person’s degree of frailty with high validity.^{1Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 431.}

ACSM names frailty and sarcopenia as consequences of low physical activity in older adults.^{2Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 429.} Losing strength later in life is a primary risk factor for frailty.^{3Schoenfeld and Snarr (eds.), NSCA’s Essentials of Personal Training, 3rd ed., p. 85.} Low muscular power is linked to a greater risk of functional decline, falls and frailty.^{4Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 443.} Women show higher frailty index scores than men in every age group.^{5Schoenfeld, Science and Development of Muscle Hypertrophy, 2nd ed., p. 183.}

In practice

• Keep clients lifting for life; continued resistance training helps limit the effects of aging.^{3Schoenfeld and Snarr (eds.), NSCA’s Essentials of Personal Training, 3rd ed., p. 85.}
• Add power work such as medicine ball throws and kettlebell swings for older adults.^{4Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 443.}
• During very-low-calorie diets, ACSM recommends resistance exercise and at least 1.2 g of protein per kg of body weight, especially for people prone to sarcopenia and frailty.^{6Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 693.}
• Formal exercise testing may be an unnecessary barrier for people with frailty, since muscle fatigue may limit their performance.^{7Ozemek et al., ACSM’s Guidelines for Exercise Testing and Prescription, 12th ed., p. 781.}