About Physiatry

About Physiatry

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Geriatric Frailty

Condition: “Geriatric frailty” is the result of decline in multiple physical functions and health that some individuals experience as they get older.

Background: It is important to recognize that frailty is not a natural result of aging, but instead a condition involving gradual loss of muscle strength and function. 30% of older adults are considered frail by age 90 in the U.S.

Risk Factors: Risk of frailty increases with age. Women are more at risk than men, and people in lower income levels are also at increased risk. It is more common in African Americans and Asians compared to Hispanics and Caucasians.

History and Symptoms: Frail elderly persons often experience muscle weakness, falls, balance, and walking issues. Additional symptoms may include poor vision, cognitive (thinking) difficulties, weight loss, and depression.

Physical Exam: Physicians check a wide range of functions, such as a person’s muscle coordination and strength, vision, hearing, cognition, and mood.

Diagnostic Process: A person is considered frail if three or more of the following five criteria are met: weight loss of 10 pounds or more in the past year, exhaustion, weakness, slow walking speed, and decreased physical activity. Blood work can also be helpful to determine if symptoms are due to another medical condition.

Rehab Management: Each individual should have his/her medication regimen reviewed to minimize, as best possible, the overall number of medications and to choose medications and dosages to prevent side effects. Nutrition should be assessed to ensure a balanced diet. Environmental factors, such as financial resources or physical barriers (lack of transportation), should also be assessed. Older adults should participate in an exercise program that includes aerobic, resistance, flexibility, and balance exercises. These exercises will help develop and strengthen muscle as well as improve balance to prevent falls. 

Working with a physical medicine and rehabilitation (PM&R) physician will enable a complete evaluation of all factors that may be contributing to a patient’s symptoms. A PM&R physician will also work with a patient and their family to develop the best approach to a treatment plan to help improve symptoms and serve as an advocate when discussing treatment plans with your other doctors and therapists.

Other Resources for Patients and Families: Families and caregivers often put their own finances and health at risk while caregiving. Resources such as the Eldercare Locator—a nationwide governmental service that connects older Americans and caregivers with information on senior services—can help.

For Patients and Families:

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