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Why People Become Frail with Age and How to Prevent It

Why People Become Frail with Age and How to Prevent It

Bodies change with age, especially if you don’t do upkeep like exercise and eat a healthy diet. As we age, we lose muscle mass and gradually gain body fat. For women, these changes speed up after menopause as sex hormone levels, including estrogen and testosterone, decline. Unless you practice “preventative maintenance,” you could enter your senior years weaker and frailer than you’d like to be.

Loss of muscle tissue and strength with age is called sarcopenia, a problem of epidemic proportions in Western countries. As people lose muscle, they also lose bone. In addition, insulin sensitivity declines, increasing the risk for problems like type 2 diabetes, weight gain, and heart disease. Sarcopenia and bone loss are major contributors to frailty.

Frailty is a risk factor for falls and fractures and makes you functionally less fit so you can’t enjoy being as physically active. It’s not just muscle tissue you lose with age: bone loss accelerates too. This creates a “perfect storm” of factors that make life difficult when you reach a certain age. Of course, it doesn’t have to be that way. It’s now clear that we can prevent or greatly delay these changes through nutrition and exercise.

 What Causes People to Become Frail with Age?

Loss of muscle and bone mass are the underlying causes of frailty, but let’s dig a little deeper. A study published in the journal Nutrients points out that decreased levels of a hormone called IGF-1 is a driving force behind frailty. IGF-1, also known as insulin-like growth factor, is a hormone produced by the liver in response to growth hormone. IGF-1 acts directly on muscle tissue to promote growth. In fact, IGF-1 is a hormonal player that helps you build lean body mass in response to resistance training.

Maintaining Lean Muscle Mass as You Age

To build and maintain lean body mass, you need to challenge your muscles, by progressively exposing them to loads they aren’t accustomed to. This allows them to adapt and grow. Muscles also need nutritional support to grow. A well-balanced diet with an adequate and balanced amount of vitamins and minerals is essential. In fact, research shows certain minerals, particularly magnesium, selenium and zinc support muscle growth by enhancing IGF-1 activity.

Studies show a number of adults, particularly older adults, may not get enough of zinc, magnesium, and selenium to support IGF-1 activity. A study published in the American Journal of Clinical Nutrition in 2014 showed elderly women who took a magnesium oxide supplement for 12 weeks experienced improvements in physical function even without exercise training. Good sources of dietary magnesium include nuts, seeds, whole grains, legumes and green, leafy vegetables.

Another study found that around 40% of elderly people don’t get enough dietary zinc. In addition, older people don’t absorb zinc as well. Not only is zinc important for preserving muscle mass via IGF-1 activity, but zinc deficiency is also linked with inflammation, a factor that contributes to a number of age-related health problems. Research published in the European Journal of Clinical Nutrition also showed senior women are at risk for deficiency of the trace mineral selenium.

What about vitamins? Low vitamin D was linked with frailty in older men in one study while another study showed older women with low vitamin D were more likely to be frail and sarcopenic.  Vitamin D is important for maintaining healthy muscles and bones. People who have low levels of vitamin D often experience muscle weakness and fatigue.

A balanced diet that contains all of the essential vitamins and minerals is vital for preventing frailty, but getting adequate vitamin D, magnesium, zinc, and selenium could be especially important.

 The Importance of Protein

Considering the important role protein plays in muscle repair, it’s not surprising that a diet higher in protein might be beneficial.  A study published in the Nutrition Journal showed that older women who ate a higher protein diet had a lower incidence of frailty.  Recent research shows seniors need more dietary protein than younger people because they’re less able to synthesize muscle proteins. Current protein recommendations for sedentary younger adults are 0.8 grams of protein per kilogram of body weight. Some studies suggest that older adults would benefit from 1.1 to 1.3 grams of protein per kilogram of body weight.

The Role Exercise Plays in Preventing Frailty and Sarcopenia

As you might expect, exercise is an essential part of any frailty prevention plan, and resistance training reigns supreme because it preserves functional strength and helps prevent sarcopenia. Functional strength training, core work, and balance exercise help build a body that’s more resistant to aging as well as reduce the risk for falls. Aerobic exercise helps to build endurance. As you can see, a balanced training program, with a special focus on strength training, is best for age-proofing the body.

What does this mean? It’s never too late to get the benefits of resistance training. Studies in nursing home residents in their 90s show they’re capable of doubling their strength and increasing lean body mass. Still, the best time to start is NOW.

The Bottom Line

No one wants to become frail and unable to do the things they enjoy. Sarcopenia is the main cause of frailty and that can be prevented, in most cases, with nutrition and resistance training.

 

References:

Life Extension News. Volume 17, No. 7. August 2014.

Nutrients. 5: 4184-205 (2013)

J Gerontol A Biol Sci Med Sci. 1995 Nov;50 Spec No:5-8.

Am J Clin Nutr September 2014 ajcn.080168.

Science Daily. “Zinc deficiency mechanism linked to aging, multiple diseases”  (October 2012)

European Journal of Clinical Nutrition (2006) 60, 85-91. doi:10.1038/sj.ejcn.1602271; published online 24 August 2005.

Nutr J. 2013 Dec 19;12:164. doi: 10.1186/1475-2891-12-164.

Am J Clin Nutr May 2008 vol. 87 no. 5 1562S-1566S.

Am Med Dir Assoc 2013;14:542-59.

J Clin Endocrinol Metab. 2013 Sep;98(9):3821-8. doi: 10.1210/jc.2013-1702. Epub 2013 Jun 20.

Science Daily. “Low and high vitamin D levels in older women associated with increased likelihood of frailty”

Medscape Family Medicine. “Prescribing Exercise for Frail Elders” (2002)

 

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