Prevention of frailty

As I keep repeating, frailty is not inevitable – it can be prevented – and prevention works much better than trying to treat it after it has  developed. The good news is that many of the steps to prevent frailty are simple, practical, and can be started at any age. The earlier you start, the better, but it’s never too late to make positive changes.

Frailty has two main features – inadequate physical fitness and inadequate muscular strength. To maintain our ability to be active and independent means being able to move about under our own steam and to be able to lift and carry items which we use in our daily life.

So, the basis for prevention of frailty, or treatment if needed, is physical activity.

Maintaining physical fitness

As the years speed by so does our fitness level. We reach peak fitness in our early twenties and thereafter, however hard we try, our fitness declines gradually.

A measurement such as the gold standard of fitness, VO2max (See “Physical fitness” in the index), declines by about 1 to 2% each year. Eventually this can fall to below the level required to maintain our ability to remain independent – and this is what defines frailty.

Regular exercise or physical training can slow this process so that even in our late nineties we are fit enough to be able to look after ourselves and, indeed, we may never become frail.

However, leading a sedentary life without enough regular exercise allows the rate of decline in our fitness to be more rapid so that we reach this tipping point in our early eighties or even sooner.

What can we do?

We can follow the government recommendations of taking at east 150 minutes a week of moderate activity. Walking is an excellent way of doing this. Half an hour’s walking a day is easy, cheap and requires no special skills or equipment. It can be done on your own, as part a member of a walking group or just walking the dog.  Alternatives and/or additional exercise can include dancing, swimming, cycling and also other day-to-day activities like house work or gardening. You could choose to go to the gym. And if you enjoy playing games or competing, tennis, padel tennis, badminton, walking football, swimming and countless other ways of taking exercise are out there waiting for you to embrace them. For more ideas go to the Alton Town Council website for a full list of possible activities https://alton.gov.uk/active-alton
A printed version is widely available at such venues as doctors’ surgeries, the library or the Community Centre.

Maintaining muscular strength

Remember that oft forgotten Department of Health  recommendation – to  include strength exercises at least twice a week. This doesn’t necessarily mean lifting heavy weights at a gym; it can be as simple as using resistance bands at home, doing chair exercises, or carrying shopping bags.

The NHS website includes a useful range of such exercises at https://www.nhs.uk/live-well/exercise/strength-exercises/

Anything else?

Well yes, though physical activity remains the most important.

Diet

Eat sensibly and include plenty of protein. Include fish, eggs, beans, lean meat, dairy, nuts, or tofu in your meals. An adequate intake fruit and vegetables is needed for their vitamin and mineral content. Consider vitamin D, especially if you don’t get much sunlight. Low vitamin D is linked to muscle weakness and falls. Vit D is found in fatty fish (salmon, herring, mackerel, sardines), cod live oil, egg yokes and as an aditive in fortified products such as milk and cereals.

Staying connected

Social isolation isn’t just about feeling lonely – it actually increases the risk of becoming frail. People who stay socially active tend to stay physically and mentally active too.
Keep up with friends and family. Regular phone calls, video chats, or visits all help.
Join groups or clubs based on your interests – book clubs,
walking groups, community centres, or volunteer organisations.
Stay involved in your community. This gives you a sense of purpose and keeps you engaged.
If you’re struggling with low mood or anxiety, talk to someone. Mental health and physical health are closely linked.
Consider getting a pet if you’re able – they provide companionship and dogs ensure you get regular walks.

The bottom line

Prevention is not only more effective than treatment, it’s also more enjoyable. Staying active, eating foods you like, and spending time with people you care about aren’t sacrifices – they’re investments in your future that pay dividends in health, independence, and happiness.

Start where you are, do what you can, and remember: small changes add up to big results over time.

Next time, by special request: Cramp.
Which reminds me, please let me know if you have any particular topics you would like me to address.