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Johns Hopkins Health Alert

Unraveling the Mystery of Frailty

Johns Hopkins Health Alerts | Healthy Living After 50 | Unraveling the Mystery of Frailty

Geriatrician Dr. Linda Fried explains that frailty is not a disease in the classic sense, but a syndrome -- a constellation of symptoms that characterize a certain condition.

Though there’s no shortage of warnings about the dangers of obesity, older people should also be concerned about frailty. According to research spearheaded by geriatrician and epidemiologist Linda Fried, M.D., M.P.H., Founder and Director of the Johns Hopkins Center on Aging and Health, frail people are more likely to fall, be hospitalized, be disabled, or suffer from a variety of diseases and chronic conditions.

Because frailty makes it more difficult to cope with or recover from these major life stressors, frailty also tends to be associated with a significantly higher mortality rate. Knowing the warning signs of frailty may help you to shore up your strength as you grow older.

According to Dr. Fried, "Older adults know who is frail, they are concerned about it, and they don’t want it to happen to them.” But until recently, frailty did not have a medical, or clinical, basis. This changed in the late 1990s, when Dr. Fried set out to discover a way to recognize frailty early and therefore prevent the worst of its consequences.

Over the course of seven years, Dr. Fried and her colleagues examined the health of over 5,000 men and women ranging from 65 to 101 years of age. They found that the weakest, most physically disabled people shared a unique set of observable symptoms that together suggested frailty. They defined a phenotype of frailty by classifying people with three or more of the following characteristics as clinically frail:

  • Unintentional weight loss, including sarcopenia (loss of muscle mass), of 10 lbs. or more within one year.

  • Exhaustion that prevents normal or enjoyable activities.

  • Weakness characterized by significant reduction in grip strength.

  • Slow walking speed.

  • Low physical activity (burning less than 3,830 calories per week for men and 2,700 calories per week for women).

Johns Hopkins Health Alerts | Healthy Living After 50 | Unraveling the Mystery of Frailty

Posted in Healthy Living on September 12, 2007
Reviewed June 2008

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Users and editors may post comments here at their own discretion. The views expressed do not constitute medical advice and do not represent the position of Johns Hopkins Medicine or University Health Publishing, which has no responsibility for its content.




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