It’s inevitable: as we age we begin to lose a lot of what we took for granted when we were younger, such as strength, speed, endurance, balance and flexibility. At some point we may become “frail,” a term yet to be clearly defined but one that generally refers to older adults who are weak, exhausted, have limited physical function, and walk slowly – if at all (1;2).
There is no way to predict when someone will become frail. We know of seniors in their 80s and 90s who are still healthy and active and show no signs of slowing down, while people 20 or more years their junior are already struggling with mobility issues and performing routine tasks.
Keeping older adults active and independent for as long as possible – while promoting their health and safety – are priorities for our healthcare system. Seniors who become frail are at greater risk of falling, getting hurt, becoming disabled and being hospitalized (3). For seniors and their families, symptoms of frailty seriously detract from a good quality of life and enjoyment of those “golden years.”
So what can be done? Physical exercise has long been prescribed as a way to improve physical functioning in older adults and several relevant studies have shown promising results (4;5). Research specific to frail older adults was the focus of a systematic review to determine if exercise improved mobility, walking speed, muscle strength, balance and endurance (6). The review examined 19 randomized controlled trials involving more than 1,500 community-dwelling older adults. Participants took part in multi-component exercise programs including aerobic and strength training activities.
What the research tells us
The results were encouraging for at least some outcomes: physical exercise appeared to significantly increase walking speed and to modestly improve other aspects of movement and mobility in frail older adults (6). An even more recent umbrella review looking at multicompetent exercises—which included aerobic, balance, resistance, and flexibility activities—in community-dwelling older adults who were frail or at high-risk of becoming frail lent further support to previous findings on walking speed and physical performance. Additionally, it highlighted new benefits such as the potential for improvements in muscle strength and balance. In terms of stand-alone exercises, resistance training seemed to be especially effective in enhancing muscle strength, walking speed, and physical performance (7).
More research is needed on how often or at what intensity exercises should be performed for the best results. Research to address such questions will help in the design and delivery of more effective programs to help older adults stay active, engaged and moving with confidence (6;7).
Many of these types of exercise can be done at home. This is handy during instances that call for spending more time at home and physical distancing, similar to what we're experiencing with the current COVID-19 pandemic. Being at home for long periods of time can decrease activity levels, so for folks who are frail or pre-frail, keeping physically active in this setting is vital for reducing the progression of frailty.