Preventing Frailty with Yoga

by Nina

Old Woman with a Shawl and a Walking Stick
by Vincent van Gogh

“The fundamental problem with frailty is a reduced ability to bounce back from biological insults, such as infections and injuries. A relatively minor illness from which a non-frail elderly person would readily recover can throw a frail patient into a downward spiral of additional illnesses, sometimes leading to death.” —Richard Gunderman, The Atlantic  

Although I wrote about frailty a long while back (see Any Activity is Better Than None), I focused mainly on the recommendation to use exercise to preserve your muscle mass and strength in order to help you avoid declining from vitality to frailty as you age. I quoted a New York Times article "Aging Well Through Exercise" that cited several studies on exercise and aging, and included the following quote:  

“We think these are very encouraging results,” said Dr. Vonda Wright, an orthopedic surgeon and founder of the Performance and Research Initiative for Masters Athletes at the University of Pittsburgh Medical Center, who oversaw the study. “They suggest strongly that people don’t have to lose muscle mass and function as they grow older. The changes that we’ve assumed were due to aging and therefore were unstoppable seem actually to be caused by inactivity. And that can be changed.”  

But I didn’t really define what frailty is or why it is so important to prevent it. Now I’ve read a new article from The Atlantic The Challenge of Treating Frailty, which I felt did a good job of defining exactly what frailty is.

Two elderly patients are admitted to the hospital. Both have the same condition, maybe pneumonia, maybe a hip fracture. Both are the same age. And both will get more or less the same medical care. The difference is hard to pinpoint, but from the moment they enter the hospital, a doctor can often tell that one will do well and the other poorly.

For a long time, medicine lacked a term to describe the patient who would do poorly, but now we have one: frailty. Frail patients are not sick—they have no particular diagnosable disease. But if they do fall ill or suffer an injury, they are much more likely than non-frail patients to fare badly. In one study that followed a group of elderly patients over seven years, the frail were more than three times likelier to die than their non-frail counterparts.

The article goes on to say that that precise definition of frailty is still evolving, but that frail people generally share a number of traits:  

• weight loss of more than 10 pounds in the last year
• frequent exhaustion
• low levels of activity
• slow gait
• poor grip strength

The article concludes by saying that our health care system is set up for treating frailty because it is designed around the diagnosis and treatment of particular diseases. So an elderly person who is suffering from frailty in general will go untreated until they suffer a crisis—at which point it is too late.

“To respond effectively to the challenge of frailty, the traditional approach of waiting to intervene until older people develop particular diseases won’t work. But promoting a more robust state of health through living habits could decrease vulnerability.”

So what are these “living habits” you may be wondering. As I already wrote in Any Activity is Better Than None, the big one is, of course, exercise, which not only preserves muscle mass and strength, but also, as the article says, "enhances the function of the brain, the endocrine system, and immune system." Yoga, of course, provides a very adaptable form of exercise that be done by people of any level of ability or state of health, so it’s a form of exercise that is suitable—and beneficial—for people of any age. And although the article didn’t mention flexibility, balance, and agility as important physical skills to maintain as you age, we’re pretty sure these physical skills that yoga helps you maintain—along with strength—are important for preventing the development of frailty.

The article mentions two other living habits:

Good Nutrition. While the article says a well-balanced, varied diet that includes adequate amounts of calories and protein is important for avoiding frailty, it only recommends making that happen by having other people should check on the elderly to make sure they’re eating right. But what if you’re the elderly person? I’d say that one of main reasons older people don’t eat well is that it can be difficult for them, especially if they are frail, to shop for and prepare food. So practicing asana to keep up your strength is going to have the benefit of making it easier for you to take good care of yourself by eating well.

Psychological Resilience. The article says that “relationships with others and cultivating a positive, hopeful outlook on life plays a big role in helping many older patients stay active and vital.” On our blog, we’ve talked about the importance of community for healthy aging Sangha: The Importance of Community and provided information about how you can join the yoga community can support you Eight Ways to Join the Yoga Community. We’ve also talked about how managing your stress levels can help prevent depression and anxiety (see Anxiety, Yoga, and Brain Chemistry and keep you psychologically robust as well as physically robust. And, finally, we have many posts about how yoga philosophy can help you cultivate equanimity as you age, allowing you to stay connected to life instead of withdrawing into inactivity and solitude (see Positive Psychology vs. Yoga Philosophy).

I don't know about you, but I think we're not only up to the challenge of "treating frailty" by getting older people to start doing yoga (see Yoga May be the Best Activity for the Elderly), but we are also excellently prepared to prevent frailty from developing in the first place. Yesterday I wrote about healthy aging in general (see Yoga for Healthy Aging is Not Science Fiction) and how our mission here at YFHA was to help you understand the ways that yoga can help you increase your health span. Using yoga to help prevent frailty as you age is exactly one of the things we had in mind.

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