Nutritional Strategies Give Hope to the Frail Elderly

As more and more people find themselves living longer, physical frailty can be a concern since it may increase the risk of falls, disability and death. But the good news is that advances in medicine and nutrition research are giving hope to the frail elderly and those who care for them.

Years ago there was no recognition in the medical community of frailty as a medical syndrome, no agreed-upon definition or validated screening tools, no clinical guidelines, and consequently not much hope for the frail elderly. Now things are different. Since 2012 we have a consensus statement from six international, European and U.S. societies that physical frailty is an important medical syndrome with clear diagnostic criteria, and simple, rapid screening tests to recognize it early.

But most importantly, we, as health and wellness professionals, now recognize that physical frailty is manageable – and there is some evidence that exercise, calorie and protein supplementation, vitamin D and wise medication management may help improve outcomes. In fact, early intervention has the potential to improve the quality of life for frail elderly people and reduce costs of care.

The link between milk and yogurt and the reduced risk of frailty is interesting. The primary investigator, Dr. Alberto Lana, said “it seems reasonable to hypothesize that milk consumers become less frail due to the effect of milk proteins and certain minerals, which could improve muscle and bone quality.” In fact, a body of physiological and clinical evidence indicates that calcium, protein and vitamin D, which are contributed to the American diet by dairy foods, work together to support skeletal muscle and bone in adults. Eating recommended amounts of dairy foods may help to supply nutrients that are important for maintaining healthy bones during aging.

So how much protein do older adults need? Increasing evidence supports that older adults may need more protein than current recommendations. A position paper from a group of international experts provides updated, evidence-based recommendations for optimal protein consumption for healthy older adults and for those with a variety of medical conditions. The authors recommend incorporating protein in greater amounts than the Recommended Dietary Allowance in the meal plans of older adults due, in part, to associations with reduced risk of certain health conditions including frailty. Specifically, the study group recommends that healthy (i.e. normal kidney function) adults over age 65 consume 1.0 to 1.2 gm of protein per kilogram of body weight every day to help them maintain and regain lean body mass and function. This falls within the Institute of Medicine’s recommended range of protein consumption (10-35 percent of calories).

More research is needed to help fine-tune protein recommendations regarding protein source/quality and timing of consumption in various populations of older adults.

What we have learned so far about how to nutritionally help the physically frail should give hope to families and impetus to health and wellness professionals to implement effective strategies on behalf of those most vulnerable.