Frailty

Frailty, or weakness, means the body cannot handle problems as well as it should. When they have an infection, frail people cannot fight it off very well. When they have accidents, their injury is worse than in stronger people. When they work or exercise, they tire easily. They slow down and are limited in what they can do.

WHY DO OLDER ADULTS WITH HIV HAVE FRAILTY?

Some people with HIV become physically weaker. This might be caused by HIV’s effect on the body, or by other unknown factors some of which are part of the aging process.

WHAT HAPPENS WHEN YOU ARE FRAIL?

Frail people are weak and cannot get around very well, making it harder to work, exercise, do housework, go to the store, or do what they enjoy.

They are more likely to fall, more likely to be injured seriously if they do, and more likely to be hospitalized because of an injury. When they have surgery, they often need more time to heal. They also have a greater risk of death.

HOW DO I KNOW IF I AM FRAIL?

There are many tests for frailty, but researchers don’t agree on the best ones. Different doctors may use different tests. In general, you might be frail if you are weak, slow, easily tired, or losing weight.

What you can do with your doctor

TELL YOUR DOCTOR IF YOU ARE LOSING WEIGHT

Losing weight can worsen frailty. Find out why you are losing weight. If the cause can be identified, treatment can often help. Ask if a nutritionist can help.

 TELL YOUR DOCTOR IF YOU ARE WEAK

Your doctor may send you to a physical therapist, who can teach you how to exercise to get your strength back. Don’t be embarrassed to use a cane or walker if you’re advised to do so– these tools can literally save your life. If you are given a cane or walker, ask for clear instructions on how to use it properly.

TALK TO YOUR DOCTOR BEFORE HAVING SURGERY

Frail people are more likely to have problems after surgery. Ask your doctor if the procedure is worth the extra risks caused by frailty.

If you need the procedure, ask what can be done to avoid a long hospital stay or other problems. Your doctor might send you to a nutritionist or physical therapist to work on your weight and your strength before the surgery. Follow-up physical therapy is important to anyone who has had surgery, and more important if the person is frail.

EAT A HEALTHY DIET

Food helps the body fight infection and gives it energy and the body needs the right foods to stay strong. If you’re not sure how to eat what food is best for you, ask a nutritionist for help. This is especially important if you have other conditions, such as diabetes or kidney disease, that have their own dietary restrictions.

What you can do yourself

TAKE YOUR MEDS CORRECTLY

Take the right amount of pills at the right time of day. Use a pillbox, set an alarm, or ask someone to remind you. Taking pills correctly helps prevent and control illnesses, and allows the body to become stronger.

EXERCISE

Exercise strengthens bone and lowers the chance of accidents and falls. Even a little bit of exercise helps, so any exercise is better than none. Simply walking and using stairs instead of elevators can help. Load-bearing exercise, (lifting weights or using weight machines) often called resistance training, has been shown to be particularly effective at improving bone strength, even in people over 70. If you are not sure where to start, see a physical therapist – don’t just join a gym without getting some training first.

A Sangarlangkam MD, R Havlik MD, S Karpiak PhD, J Appelbaum MD. Staying Healthy with HIV as You Age (2016). Published by the AAHIVM HIV Aging Consensus Project

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