Frailty

What is frailty?

Frailty is a medical condition that affects many older adults. It means the body has less strength and is less able to recover from illnesses or stress.

Getting older doesn’t always mean someone will develop frailty, but it does increase the chance of having multiple medical conditions, including frailty.

Things that can contribute to frailty include:

• Not being active
• Poor nutrition
• Feeling socially isolated or lonely
• Taking many medications  

When someone is living with frailty, even small illnesses – like the flu – can cause a sudden and serious change in their health.

Older adults living with frailty:

• Can have declines in their health from minor illnesses.
• Are more likely to be hospitalized, need extra care or die sooner.

It’s important to remember that frailty is not the same as aging. Some older adults are very healthy and strong, while those living with frailty are at a higher risk for decline in their health, including death, than what is expected based on age alone.

Common signs of frailty

People living with frailty often have three or more of these five signs:

• Losing weight without trying (about 10 pounds or more in a year)
• Weak muscles
• Feeling very tired
• Walking more slowly
• Not being very active

Frailty can make everyday tasks -- like bathing, dressing or cooking – more difficult. The person may need some extra help to live at home.  

Frailty can also lead to:  

• Difficulty moving around
• Falls
• Sudden confusion, especially when sick. Learn more about delirium at Delirium | Nova Scotia Health
• Dementia (learn more about dementia at Alzheimer Society of Nova Scotia)
• Longer hospital stays
• Higher risk of death

Frailty can often be prevented and may even improve with the right care and support.  

Lower your risk of frailty by:

Staying Active

Regular activity helps you stay strong, mobile and independent. Activities that build muscle, improve balance and increase your heart rate are especially helpful.

It’s never too late to start—people in their 80s and 90s can still gain muscle strength. Exercise can slow or even reverse early frailty.

Sleep also matters. Adults over 65 still need 7–8 hours of sleep each day.

Getting vaccinated

As we age, our immune system becomes weaker. Vaccines are safe and can protect you from infections that may lead to hospitalization.

Adults should receive:

• A high-dose flu vaccine every year (65+)
• A shingles vaccine (50+)
• A pneumonia vaccine (50+)

Regular hearing and vision checks also help prevent falls and other health problems.

Reviewing your medications

About one in four Canadian adults over 65 take 10 or more medications. Some may no longer be needed, while others might cause side effects like confusion, dizziness or poor nutrition.

Ask your healthcare provider to review all your medications regularly — including prescriptions, vitamins and the-over-the-counter products.

Staying connected

Loneliness can be harmful. People who feel socially isolated have a higher risk of early death, high blood pressure, depression and dementia.

Staying socially active can improve your mood and help prevent frailty. Try:

• Joining a club
• Taking a class
• Volunteering
• Staying in touch with friends and family

Eating enough healthy food

Food is like medicine. As we get older, our bodies need more of certain nutrients and getting good nutrition can lower your risk of frailty and help you stay well for longer.

• Protein from foods like fish and eggs helps keep our muscles and bones strong.
• Vitamin D and calcium also keep bones and muscles healthy and may help prevent frailty.

This information is based on the Canadian Frailty Network’s AVOID Program for Healthy Aging.

Learn more: AVOID Frailty – Program for Healthy Aging

Download: Canadian Frailty Network Avoid Frailty Brochure

Frailty and hospital stays

Frailty can lead to health problems that cause longer hospital stays. Unfortunately, being in the hospital can sometimes make frailty worse. Older adults (65+) may:

• Lose muscle strength
• Become confused or tired
• Have trouble sleeping
• Stay in hospital longer
• Need nursing home care
• Face a higher risk of dying

Older adults with frailty are:

• Three times more likely to stay in hospital for 30 days or more
• Two times more likely to return to hospital within 30 days of returning to the place they call home

Home First approach

At Nova Scotia Health, we take a Home First approach. Evidence shows that healing happens better at the place you call home. Home First is more than a philosophy, it's about:

• creating a discharge plan with the goal of getting you back home.
• providing the care you need to keep living at home.

We start planning for your discharge home as soon as you are admitted to the hospital. Our goal is to connect you with the right community resources to support your recovery, independence and quality of life outside of the hospital.

Staying active while in hospital

While in hospital, getting up, dressed and moving has many benefits. It can help you recover faster and stay strong. Each day, you will be expected to move around as much as you can. Take part in your care, like washing or getting dressed and try to get out of bed for all three meals. This helps to prevent blood clots, build strength and improve breathing.  

Your care team will support you to stay active to help you keep up or rebuild your strength and independence.

Learn more about some of the things you might expect from the time you enter hospital (get admitted) to the time you leave (get discharged) on the What to expect when you need hospital care page.

Early Mobility Program

The Early Mobility Program helps patients stay active by supporting them to walk every day with a member of the mobility team while they are in hospital.

Staying mobile in the hospital can help people maintain their strength and return to the place they call home sooner.

Once home from the hospital, you can recover better when you are in a comfortable place with familiar routines, family and access to community support. This can enhance your physical and emotional recovery and more choices and preferences to help you get back to your daily routine.

Learn More

Health team focuses on changing ‘risk culture’ to improve lives of older adults living with frailty and dementia