Frailty Indicators in Older Adults

We all want to live long, healthy lives. The healthier we are in our old age, the better our chances of living independently and enjoying our retirement. So how do we avoid becoming frail – or losing our energy, strength, and speed as we age? Researchers have been trying to figure this out for a while now. Awareness of frailty indicators can help ensure older adults get the assistance they need before a serious problem arises. 

The idea is that the earlier doctors can detect frailty, the earlier it can be diagnosed and treated. The most important study on frailty reveals that it just might be associated with genetic variants, which means a simple genetics test can determine if you’re at risk. But before we get into the study, let’s define frailty.

Frailty Definition: What is Frailty Syndrome?

Frailty is a geriatric syndrome characterized by weakness, energy loss, weight loss, and low physical activity. It is not generally considered a disease but is associated with aging.

Interestingly, frailty can manifest differently for each individual, and some have even reversed the syndrome early diagnosis and intervention. 

About 15 percent of Americans age 65 and older are considered frail, and about 45 percent are deemed prefrail. 

This is a problem because frailty increases the risk of disabilities, infections, and illnesses. For example, in a Johns Hopkins Study, researchers found that frailty “doubles the risk of surgical complications, lengthens hospital stays, and increases the odds of moving to a nursing home or assisted-living facility after a surgical procedure by as much as twentyfold.”

As such, substantial research is being done to find biomarkers or genetic features to promote early detection and prognosis.

The Study: Is Frailty Genetic?

In a recent study, Marta Inglés and colleagues hypothesized that frailty is related to biologically relevant SNPs, genes, and pathways that may help in the early diagnosis of frailty and the response to treatment strategies, thus avoiding its negative outcomes. 

The team conducted a longitudinal population-based cohort of 152 community-dwelling people in Spain. In this study, researchers took a broader approach to identify several potential genes and molecular pathways associated with frailty.

Here Is What They Found

In total, they found 15 SNPs, 18 genes, and four pathways with significant relationships. 

Among them, 3 SNPs are located on the alcohol dehydrogenase 4 (ADH4) gene, which is associated with a better overall prognosis in certain cancers. 

More specifically, participants with at least one copy of the T allele of SNP rs4148883 on ADH4 showed an increased risk of developing frailty. 

On the other hand, they found that having at least one copy of the G allele of SNP rs613444, located on the nuclear factor I/B (NFIB) gene, provided participants with a protective effect against developing the geriatric condition. This gene has been proposed as an oncogene, which is overexpressed in some cancers (like lung cancer), promoting cell growth and proliferation.

Frailty Indicators in Older Adults

A frailty index was developed by Dr. Kenneth Rockwood and Dr. Arnold Mitnitski to measure the health status of aging adults. The index was created to provide a replicable tool that would help healthcare workers assess the needs of elderly patients. By asking a series of questions, healthcare professionals can measure deficits objectively across all circumstances. 

According to the frailty index, there are ten frailty indicators to be aware of, including:

• Needing help to get out of bed
• Needing help to wash or bathe
• Unintentional weight loss or gain of more than 10 pounds in 6 months
• A poor appetite or feeling full quickly when eating
• Physical or emotional problems that interfere with social activities
• Self-assessing health as poor
• Tiring easily
• Being hospitalized within the last three months
• Visiting the emergency room for a health issue in the last three months

A score of zero on the index suggests no frailty is present. Scoring one to three indicates a risk for frailty, and a score of four or more is affirmative for frailty. 

If you’re concerned about frailty risks for yourself or a loved one, you can now determine if you’re at risk by taking a genetics test.

Genetics tests are available through many companies, like AncestryDNA, 23andMe, and MyHeritage. So, you might have already completed a test. If this is the case, you can ask for your raw DNA file and then upload it to a different website that offers physical traits genetics testing and analysis. 

If you haven’t had a genetics test, you’ll need one before learning all about your physical traits. 

The Bottom Line

Of course, the risk of developing frailty is not entirely explained by our genetics. It is a systemic syndrome influenced by a combination of environmental, genetic, and epigenetic factors that may alter gene expression. 

Although this study was conducted in limited geographic regions, the results provide an important foundation of knowledge on which future research can build our understanding of frailty.

Are you interested in learning more about your genetic tendency for frailty? You can login to your Genomelink dashboard to see these latest updates now.

‍

Photo by Matthew Bennett on Unsplash