The fragility of the elderly: possible preventive actions

While life expectancy has been rising for more than a century, life expectancy "in good health" seems to be falling gradually. Faced with the fragility of the elderly, preventive actions exist.

In view of the demographic projections, which envisage an increase in the number of dependent elderly people in the decades to come, a real challenge has been imposed on the public authorities in order to detect the first signs of frailty in the elderly. The objective is to put in place prevention measures so as to keep the elderly healthy as long as possible.

WHAT IS FRAGILITY?

The elderly population can be divided into 3 distinct groups:

• Healthy or Robust Elderly: These individuals may have some metabolic disruption without affecting their physical function and quality of life.
• Frail elderly: 30% to 40% of the population aged 65 and over. These people have specific signs (involuntary weight loss, slowed down speed, muscle wasting ...) and a high risk of loss of autonomy.
• Dependent elderly people: confined to their homes or nursing homes, these people are unable to perform the basic activities of everyday life. This category represents 10% of the population aged 65 and over.

If the root causes of fragility are multifactorial (genetics, lifestyle (physical inactivity, smoking, and malnutrition), socio-economic context, disease ...), its expression is multidimensional. Indeed, different medical approaches have been highlighted in recent years, they have made it possible to highlight five criteria making it possible to identify the fragility of an elderly person:

• Mobility: slow walking speed, uncertain balance
• Undernutrition: unintended weight loss
• Decreased muscle strength
• The feeling of exhaustion
• The weakening of memory

The cumulative presence of one or two of the criteria defines the pre-fragile state, while three criteria indicate a state of fragility. Moreover, the environment (social life, family environment ...) is a non-negligible criterion that can increase the fragility of the elderly.

As a result, fragility is a state of vulnerability leading to a gradual decrease in physiological reserves. The adaptation of the elderly to the different stressful events of life (psychological, accidental or disease) being more difficult, there is a significant risk of loss of autonomy. However, fragility is a reversible state, and this is why public authorities have been focusing their actions for the past few years in order to identify and take care of the frail elderly.

WHAT ARE THE PREVENTIVE ACTIONS?

Simple measures allow you to remain healthy and maintain autonomy:

• The practice of a sporting activity
• A balanced nutrition adapted (protein, calcium ...)
• The maintenance of social life to avoid isolation
• The development of housing so as to be able to carry out all the gestures of everyday life and thus preserve autonomy
• The use of appropriate hearing and visual corrections
• The stimulation of memory by daily activities...

Source: Lescuyer Laboratory