Until recently, researchers didn't have a clear definition of "frailty," a condition that appears to put people at increased risk of developing numerous health problems. Having a clear and reliable definition of frailty is key to doing research in this area, and to identifying - and then treating - people who are likely to develop many health problems.

Doctors have often used the term "frail" to describe people who were weak or had balance problems. But that definition was vague. Recently, researchers came up with a new definition that classifies someone as "frail" if he or she has three or more of the following: muscle weakness, slow walking speed, exhaustion, low physical activity levels, or unintentional weight loss.

One recent study, in fact, showed that people who met this description ran an increased risk of becoming disabled. And some additional research has found that people meeting the description are also more likely to fall, to be hospitalized, and to die within several years.

New Research in the Journal of the American Geriatrics Society

To further test whether the new definition of frailty is precise enough to help doctors identify people at high risk of problems such as falls and disability, researchers studied information from the Women's Health Initiative Observational Study of more than 93,000 women, aged 50 to 79. The researchers focused on nearly 41,000 women who were 65 to 79 at the start of the study. The researchers examined their health records for a period of three years.

At the start of the study, about 16% of the women met the new definition of frailty because they reported having three or more of the following: muscle weakness, slow walking speed, exhaustion, low physical activity levels, and unintentional weight loss. Three years later, another 15% met the definition.

Women who were older, had chronic (or long-term) health problems, smoked, had several symptoms of depression or were underweight or overweight were more likely than others to become frail, the researchers found. Those who had higher incomes, lived alone, drank moderately, and reported that they were healthy were less likely than others to be frail.

Most important, those who were frail did, in fact, turn out to be at increased risk of multiple health problems, including hip fractures, disability, and death.

This finding suggests that the new definition of frailty really can help doctors and other health care workers identify people at risk of developing multiple health problems. This is important because, once health care workers identify these people, they can be treated in ways that can lower the odds of developing additional health problems.

What Should I Do?

See your doctor regularly and be sure to let him or her know if you smoke or often feel sad or depressed. If you smoke, are depressed, or are underweight or overweight, you may be more likely to become frail. Your doctor can help you quit smoking, enjoy better mental health, and reach a healthier weight. All these things may lower your risk of becoming frail, and of developing many other health problems.

The summary above is from the full report titled, "Frailty: Emergence and Consequences in Women Aged 65 and Older in the Women's Health Initiative Observational Study." It is in the July 2005 issue of the Journal of the American Geriatrics Society (Volume 53, Issue 8, pages 1321-1330). The report is authored by Nancy Fugate Woods, PhD, RN, FAAN; Andrea Z. LaCroix, PhD; Shelly L. Gray, PharmD, MS, MCPS; Aaron Aragaki, MS; Barbara B. Cochrane, PhD, RN; Robert L. Brunner, PhD; Kamal Masaki, MD; Anne Murray, MD, MSc; and Anne B. Newman, MD, MPH.