The word frail conjures an image of an elderly person leaning on a cane, having a hard time walking or climbing stairs or doing other daily tasks, but the medical definition is somewhat different. From a doctor’s point of view, frailty occurs when your body’s physiological reserves are depleted and it can’t get through – and recover from – illnesses and injuries on its own. Because the body is more vulnerable, it makes it harder to overcome health problems. According to Cleveland Clinic, frailty can happen to anyone, not just adults over 65. A 2024 study reported by AARP found that about 9 percent of adults ages 45 to 64 were already frail, and another 22 percent were “pre-frail,” meaning their resilience was starting to slip. “There are many causes for frailty in younger people,” says Wageha Akel, MD, who is board-certified in family medicine and practices at Cleveland Clinic’s Family Health Center in St. Lucie West. “Chronic diseases are one of them. “Cancer, thyroid disease, kidney disease and depression are some health issues that can result in weakness, unintentional weight loss, and difficulty keeping up with daily activities, which are all indicators of frailty,” she says. “Others include osteoarthritis and neuropathy in the feet, which can affect people of any age and negatively impact your balance and ability to move around. “What are the side effects of your medications?” she asks. “Does anything that you’re prescribed affect your balance and ability to walk?” Dr. Linda Fried, a professor of epidemiology and medicine at Columbia University, thinks too much muscle loss may cause a domino effect that leads to frailty. As people get weaker, they also typically move more slowly, she says. Those combined changes can cause someone to exercise less. Then, as people become less active and more deconditioned, they develop more of a sense of fatigue and low energy, she believes. Finally, as people consume fewer and fewer calories because their bodies are less active, they start to lose weight. WebMD says if you experience three or more of the following, you may be frail: <ul> <li>Unintentional weight loss of 10 or more pounds in the past year.</li> <li>Feeling weak and having trouble standing without help from someone else.</li> <li>Experiencing reduced grip strength.</li> <li>Feeling exhausted, where everything you do takes a big effort, or struggling to get moving for three or more days per week.</li> <li>Being less active and not moving around the house as much or exercising as much as you used to.</li> <li>Walking slowly, where it takes you more than 6 or 7 seconds to walk 15 feet.</li> </ul> Frailty and physical weakness aren’t the same thing. With frailty, your endurance, mental health and brain function also play a role. Frailty is like a spectrum, ranging from least severe to most. Johns Hopkins Medicine has some advice for people who feel frail: <ul> <li>One cause of frailty is the age-related loss of muscle mass. Activities like walking and easy strength-training moves improve strength and reduce weakness – even in very old, frail adults. Every little bit helps, at any age.</li> <li>Eat well. Aim for three healthy meals a day that provide fruit, vegetables, protein, good fats, whole grains and low-fat dairy products. Be sure to include enough muscle-nurturing protein.</li> <li>Keep your mind active, your attitude optimistic. Positive feelings have been shown to translate into a lower risk of frailty.</li> </ul> There’s a misconception that frailty is inevitable. It isn’t – aging is inevitable, but frailty isn’t,” says Dr. Akel. “Sometimes the smallest things can make a difference. Take your choice of shoes, for example. “Flip flops or sandals don’t offer stability and can adversely affect your balance, causing you to fall or stumble,” which indicate and/or lead to frailty. Podiatrists also caution against wearing shoes with super-thick rubber soles. thick memory foam, or low-density polyurethane insoles. While they feel comfortable at first, this cushion compresses too easily and acts like a soft mattress, creating an unstable walking surface. “People in some cultures are more liable to experience frailty than others, due to lifestyle differences,” Dr. Akel explains. “In some countries, people stay active and perform more physical labor during the course of everyday living.” The University of Edinburgh states that living in deprived areas after the age of 40 leads to greater frailty in men and women, while childhoods spent in disadvantaged areas are also linked to frailty in later life in men. Ohio State University’s Health & Discovery website says that not only is frailty avoidable as we age, it’s also something we can reverse if it starts settling in. This is especially true when it’s caught early. When someone starts showing early signs – like slowing down, feeling more tired than usual, or losing weight without trying – that’s often a sign of “pre-frailty.” It’s a signal to pay attention and start taking steps to reverse the progression. “Everyone seems to be looking for a magic pill,” Dr. Akel says. “There isn’t one. You have to start working hard now for ‘the future you’ and if you already are ‘the future you,’ you need to get started as soon as you are able. Wageha Akel, MD, is board-certified in family medicine. She received a medical degree from St. James School of Medicine and her residency at Suburban Community Hospital in Pennsylvania. Her office is located at Cleveland Clinic Family Health Center, 1095 NW St. Lucie West Boulevard, Port St. Lucie. For an appointment, call 877-463-2010.