Encouraging Physical Activity Against Frailty

A review article in Clinics in Geriatric Medicine provides a summary of how physical exercise has been shown to prevent, minimize, and even reverse frailty in older adults.


Frailty is generally understood as “a syndrome of weakness, impaired mobility, balance, and minimal reserve,” which leads to significantly increased mortality rates and illness, and significantly weakens quality of life. The article presents several findings on the predictors and consequences of frailty, demonstrating the value of physical activity for elders.


The review focuses on two forms of exercise: aerobic activities, such as walking, that improve cardiovascular health, and resistance training or strength building. The authors mention several studies that demonstrate the value of such exercise even among the oldest and more frail; for instance, they refer to one study in which nursing home residents who participated in 10 weeks of resistance training averaged a 97% increase in strength. Strength has been shown to lead to improved motor performance in older adults, which improves mobility. Further, the article presents research showing that exercise interventions reduce the likelihood of falls and limitations in activities of daily living.


The authors address some concerns about exercise interventions for frail older adults, referring to a systematic review of 62 trials of strength training that found no reports of cardiovascular events or death. Other studies and reviews mentioned suggest that whatever risks exercise does hold are overall lower than the risks of inactivity. Other factors addressed are the importance of adherence to an exercise regimen and cognitive and other disabilities. When implementing an exercise program, it is important to consider the time commitment and other possible stressors, and the need for supervision or coaching for some individuals. The review points to areas of further investigation and also further innovation, such as the development of home- and community-based programs. Given the benefits of even the most moderate aerobic activity, such as walking, and the growing body of research on the benefits of strength training, physical exercise is a promising area for the development of new programs and for individuals looking to improve their quality of life.


Liu CK and Fielding RA (2011), Exercise As an Intervention for Frailty. Clinics in Geriatric Medicine 21:101-110


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