Frailty: Putting It All Together!

Over the last few months, we have been working our way through the topic of Frailty, which is really a study of how the body unwinds over a life time. Most of the material we have been drawing from has come from an article published in "The American Geriatrics Society." While some choose to look at topics like Frailty and the unwinding of our bodies over time as a bad thing, this article and our blog series took the approach that we are "Fearfully and Wonderfully Made" and understanding how we function in youth and as we age can help us live as full and complete a life as possible! The lens that we used to look at this topic consisted of four, separate yet interrelated, segments:
  1. Inflammatory System
  2. Endocrine  System
  3. Musculoskeletal System
  4. Nervous System

The first thing we looked at was Inflammation. We saw that researchers looked at these main markers in inflammation:

  • Cytokine IL-6
  • C-Reactive Protein
  • Total number of monocytes

These were blood markers that increased with age and disease, and were related to the following disease states and functional issues:

  • Death (that is a big one)
  • Bone mineral loss
  • Muscle loss
  • Anemia
  • Insulin resistance (Adult Diabetes)

We also looked at how we could influence these various states of decline and dysfunction, primarily by how and what we ate. There are two links that can help with addressing this issue:

  1. Andrew Wiel Article
  2. Blog Summary from our Healthy Eating Series

Next, we looked at the Endocrine System.  The main markers researchers look at in the Endocrine System are

  • IGF-1
  • DHEA-S

These two markers primarily give insight into the sex hormones: Testosterone and Estrogen. These markers ebb and flow over a life time, but tend to trend down as we age, causing the following functional loss:

  • Decreased strength
  • Decreased endurance
  • Weight loss (due to loss of muscle tone)
  • Decreased walking speed
  • Decreased physical activity
  • Increased inflammation
  • Cognitive issues (dementia)

When looking for ways to positively influence these factors, we found several factors to pursue:

  1. Resistance training
  2. Weight loss/management
  3. Decreasing high glycemic index foods
  4. Increasing sleep
  5. Eating a high protein low carbohydrate snack before bed

Two links that were helpful were:

  1. Article in the Journal of Gerontology (Technical)
  2. Article in Life Extension Magazine (Reader Friendly)

After the Endocrine System, we looked at one of my favorite: the Musculoskeletal System! The main marker for this system is muscle mass or muscle to non-muscle tissue ratio.

We primarily focused on the glute muscle because it is such a big player in much of human locomotion. Decline in the musculoskeletal system results in the following disease and functional states:

  • Diabetes
  • Fall risk
  • Declining bone health
  • Independence

We referenced two helpful links:

  1. The Sit to Rise Test (explained the relationship between core strength and life expectancy)
  2. Getting Your Butt Off the Ground (blog series on how to improve the Sit to Rise Test!)

Finally, we looked at the Nervous System. We saw that the nervous system really brought everything together, which is why it is often called the Master System. The markers that were used in the original article are:

  • Gait (how stable and smoothly you walk)
  • Balance
  • Strength

We added a bonus one that has been making it's way into the literature lately:

  • Cognition (how well your brain works)

When the nervous system starts to fail, you see the following issues:

  • Falls
  • Loss of independence
  • Problems with coordination
  • Cognitive issues (mental slowness, dementia and, possibly, Alzheimer's's disease)

We linked to several articles:

  1. The Nurses Study on Walking (showed a dose-based relationship to exercise brain function)
  2. An Article in JAMA (relative to exercise and brain health - dementia and Alzhiemer's)
  3. Our previous blog series on Getting Out Of A Chair (practical place to start for glute strength)
What's Left?

As I write this article, I am 52 years old. I am sure that some of you reading are much younger than me and some older. One thing we all have in common is we are all headed to one last door in life to open.. death! We all are going to have to step through it, at some point. I have a lot to say about what I believe to be on the other side for me (the waiting arms of Jesus, who made the supreme sacrifice for me!), but that is not what this blog series has been about! This series has been about how things are going to unfold as you get to that last door. Personally, I would like to be able to walk right up to it at the end under my own power. While that may not be possible, I am going to do all that I can to operate as fully and completely as I can in the framework I have been given. I hope some of the material we have covered helps you to do the same.

In Health,

Doug Williams, D.C. Care Chiropractic Lafayette, Indiana



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