Delaying frailty, there's some simple ways to do this

13:25 pm on 13 September 2022

Healthy aging and remaining independent is entirely possible by simple healthy cooking, exercise and socialising, according to research led by an Auckland academic.

Dr Ruth Teh, a senior lecturer at the University of Auckland, has a background in human nutrition and is an expert on the health of older people.

Her current research into delaying frailty looks at our physiological reserves and how we maintain capacity to remain healthy.

She defines healthy aging as having the ability to do the things we cherish doing with our loved ones, for as long as we can.

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“The challenge we have as we grow older, is obviously there are a lot of challenges coming our way in terms of how we maintain a good diet, how we still have the motivation to continue to be active,” Teh tells Afternoons.

“As we outlive our friends, probably our social network of people becomes smaller, and the challenge is how can we enhance or embrace the network that we have.”

She says the increasing prevalence of frailty with age is becoming a public health priority in countries with ageing populations and pre-frailty presents a window of opportunity to prevent the development of frailty in community-dwelling older adults.

Her study aimed to examine the effectiveness of a complex intervention combining a nutrition-based intervention and a physical activity intervention, along with the effectiveness of each intervention individually, to reduce physical frailty in pre-frail older adults over two years.

Participants were randomly allocated to receive an 8-week senior chef programme, a 10-week strength and balance programme, a 10-week combined group, or a 10-week social programme.

Assessors ascertained frailty scores at baseline, end of intervention, and at six, 12, and 24 months after the programme.

 “I am interested in the group of people starting from 70 years old, 80 years old onwards,” Teh says.

“And the reason I say that is, it comes back to a new concept developed by the World Health Organization back in 2015, talking about this concept of intrinsic capacity.

“When we talk about the intrinsic capacity it is basically talking about the physiological reserves. Each of us, we have some level of reserves in our body, to enable us to carry on with the remainder of our life.”

She uses the analogy of a bank account where there is a healthy amount of savings – just like the body’s healthy accumulation of reserves, to carry on for longer at an optimum level.

On the other end of the spectrum, we have human frailty, which is commonly understood as weak or being vulnerable to life’s stresses.

Bones don’t heal after middle age, we recover slower from exertion before going back to our optimum functioning. Our mechanical engine declines with age and the physiological reserves deplete over time too.

“When we were young, when we were 10,15, 20 years old, we were able to do the things that we really, really enjoy. However, if you have a fall, you know, you go to a ski field with the fracture a bone or something like that. But quite quickly, we can recover in a shorter timeframe we recover and go back to our optimum function again.

“That’s part of the normal process, but what is good when we talk about the frailty, part of the thing is that if we intervene early enough, we can actually build up the reserves so that the decline can be delayed… and maintain healthy reserves of physiological ability.”

The best age to begin to intervene and build capacity is about 70, or when that person in ‘pre-frail’, she says.

“Assuming we start at the age of 70 - because of my research is talking about older people. When we have a 70-year-old person, what it means that for that person 40 percent will be in a transition state to becoming frail.

“It is in that phase we think that is the best time to intervene. That is the stage that we can actually still do something to delay that frailty."

The study showed positive results for those who took up the classes, Teh says.

 “We learned that older people do enjoy cooking classes, and the cooking class does help and is quite challenging at this stage. And it's quite challenging, especially with older people with the changes of the social circumstances them or loss of spouse, and to gain new skills of cooking…

 “In terms of the exercise group, the Sago group study as you go. I just see transformation in older people, some of them that come into being unbalanced in their feet. But just after three to four weeks, doing the exercise regularly, one hour a week list say the new person that you transform the way they do things, they transform the way they walk to the beach, the supermarket.

“They gain more confidence walking about and that is that we're encouraging them to do.”