People in England can now expect to live for far longer than ever before, but these extra years of life are not always spent in good health, with many people developing conditions that reduce their independence and quality of life.
For many of us, our life span, the length of our life, is getting longer. Unfortunately, our health span, the number of years we spend in good health, able to live an active and independent life, is not keeping pace.
Many older people are now living with one or more long term conditions with often complex health and care needs. But it does not have to be this way. Whilst environmental and economic factors play a part in how we age and are often not in our control, one of the biggest factors associated with ageing is lifestyle.
Promoting a healthy lifestyle, supporting people to make healthy choices and take responsibility for their health, is now an integral part of the NHS. If you have an appointment with any health care professional we encourage you ask them about ways that you can live longer and better.
Find out more about frailty and ageing well.
"The way we think about ageing is wrong; the new evidence from research lets us reimagine living longer and then realise the new paradigm and live longer better." Sir Muir Gray
Frailty is a term that is used a lot but is often misunderstood. When used properly, it describes a long term condition that affects how our bodies gradually lose their in-built reserves, leaving us vulnerable to dramatic, sudden changes in health triggered by seemingly small events such as a minor infection or a change in medication or environment.
In medicine, frailty defines the group of older people who are at highest risk of adverse outcomes such as falls, disability, admission to hospital, or the need for long-term care. Around 10% of people aged over 65 years have frailty, rising to between 25% and 50% of those aged over 85.
Frailty is not limited to older people but does become more common as age increases. However it is not an inevitable consequence of getting older. Whilst there are a range of factors which may contribute to an individual's tendency towards frailty, evidence indicates that a healthy, active lifestyle is key to preventing and managing this condition.
Many of the factors that cause people to age differently can be influenced by their environment and lifestyle choices such as diet and exercise. Keeping active is one of the most important ways in which people can prevent frailty and falls as they get older. Remember, it is never too late (or too early) to make some lifestyle choices that will influence how we age.
If you are concerned that you or someone you care for may have frailty, or may be at risk of falling, it is important that you speak with your GP (or another health care professional) because there are lots of ways in which you can be supported to age well.
There is strong scientific evidence that if we put into practice the knowledge that we already have, people can live longer better. Most of the serious problems that people face before their late nineties are not due to the normal, biological ageing process but to 3 other process that can be modified by individuals and society.
Explore the Live Longer Better website to find out more about the evidence behind this.
A series of short physical activity videos, to help you get active in the way that works for you, from the charities behind We Are Undefeatable.
There are multiple definitions of frailty in the literature, but it can be defined as:
"A long term condition characterised by a cumulative decline in multiple body systems and vulnerability to decompensation after a minor stressor event."
People with frailty are at significant risk of sudden and dramatic changes in their physical and mental wellbeing after a seemingly small event that challenges their health, such as a minor infection or new medication. This could mean anything from a simple episode of flu to a major intervention like a joint replacement. It increases the risk of adverse outcomes including falls, delirium and disability.
Frailty is not an inevitable consequence of ageing; rather it is a status of someone's health, a syndrome, that is a set of symptoms that collectively characterises a disease. Therefore it does not necessarily have the same trajectory as ageing. Like some other long term conditions frailty is preventable and, in those diagnosed with frailty, it can be improved. A strong focus on early screening and diagnosis is needed for early prevention.
How do we know if someone has frailty or is at risk of developing frailty? Frailty might not be obviously apparent unless actively sought in an individual.
The prevalence of frailty increases with age but age in itself is not a reliable indicator and if we are to intervene as early as possible we need to be able to employ a range of tools to identify people across the full spectrum (see links and resources below). Frailty is complex, with many different physiological (and other) systems that interact. There is no one size fits all method for identification. Frailty focuses on the whole patient, and not just on the part that seems to be the presenting illness.
Recognising that a person has frailty can direct a more appropriate assessment to enable diagnosis of an underlying cause, or combination of causes, or to effectively manage a sudden deterioration in health. This may then enable provision of a responsive and appropriate support to allow an older person with frailty to remain at home and prevent an avoidable admission or emergency department attendance.
Developing the knowledge and skills to identify and manage frailty is an important part of your skill set if you work in health and care. Being able to support people to make healthy lifestyle choices is a part of this because it is one of the major ways of preventing frailty and other long term conditions.
For help in accessing a range of voluntary, community and independent sector support services contact Kernow Gateway or your local community maker.
