Age Doesn't Mean Frailty

Just because you're 75, you shouldn't have trouble lifting a bag of groceries or getting up from a chair. But for millions of older Americans, those simple activities are a daily struggle.

Disabling frailty doesn't have to be part of aging. In fact, studies have found that even 90-year-olds can rebuild lost muscle with some careful exercise.

It would be better to never become so frail in the first place, and researchers have come up with a way to help: Fitness performance standards to let anyone 60 and older assess quickly if they're in good physical condition for their age, or if they're at risk of a downhill slide that could lead to a nursing home.

"Our main interest is in keeping people mobile and staying physically independent as long as possible," said Roberta Rikli, a professor at California State University, Fullerton. She led a study of 7,000 Americans ages 60 to 94 that established the standards.

If the tests signal you're at risk of becoming too frail, "we can do something to try to prevent that," she said.

The exercise tests are simple enough that many people could try them at home, and senior centers around the country are starting to use them.

Frailty is a huge risk of aging. By age 70, most people have at least 20 percent less muscle than they did at age 30.

About 70 percent of elderly women are too frail to lift just 10 pounds, and 60 percent cannot perform such household work as vacuuming. About 35 percent of men are equally frail.

Some of the muscle deterioration may be inevitable. But Rikli says at least half is due to people becoming more sedentary with age, meaning that keeping active is important if you want healthy retirement years.

Rikli and colleague C. Jessie Jones studied some 7,000 Americans over 60 who live independently. They performed such simple tests as:

  • How many times in 30 seconds they could rise from a straight-backed chair without using their arms to push themselves up. That measures lower body strength.
  • How many times in 30 seconds they could lift a weight -- 5 pounds for women, 8 pounds for men -- in a "bicep curl" that measures upper body strength.
  • How many yards they could walk in six minutes, to measure aerobic fitness.
  • How long it took them to rise from a chair, walk 8 feet and return to a seated position, to measure mobility.
The study, funded by a Medicare HMO provider, set standards for fitness levels that are normal, below average, or so low that people are at risk of needing a nursing home.

Say an 80-year-old woman could stand up from a chair without pushing off 10 times in 30 seconds. That's normal for that age.

But doing only 10 of these "chair stands" at age 60 is below average and while people at that level may function OK right now, they're at big risk of losing mobility by age 75.

Rikli found that fitness declined with age on average 1 percent a year. She advised people to track whether theyre declining faster than normal, or if exercise is paying off and they're improving.

Regardless of age, people who got moderate physical activity at least three times a week were the most fit.

Some doctors already use similar but experimental tests to assess elderly patients' limitations. "They're very powerful predictors" of who will wind up disabled, said Dr. Jack Guralnik of the National Institute on Aging, a pioneer of the studies.

Rikli wants such assessments to reach more older Americans. She hopes to have easy-to-read consumer brochures available by fall to illustrate the tests and show how to measure anyone's fitness level against the national standards.

"That's an excellent idea," said Guralnik. "The more people are aware of their level of functioning, the more they can tune into the fact that they need to exercise."

Already, some of the 267 senior centers that participated in Rikli's study are using the fitness assessments. She will advertise the consumer brochures in publications targeted to older Americans once they're complete. But instead of waiting, senior centers or doctors could simply check April's edition of the Journal of Aging and Physical Activity for the study results.

Written By Lauran Neergaard