5 Warning Signs of Frailty You Shouldn’t Ignore

Weakness often shows up in the legs, which can affect balance. So you might feel more unsteady or notice that you’re tripping more often.

Doctors use simple tests to check for weakness. They may see if you can stand up from a chair without pushing up with your arms. Or they may measure your grip strength with a spring-loaded device.

But you don’t need equipment to spot changes. You may simply notice that loved one’s once-firm grip has gone soft. “You get a cold, rather limp hand as opposed to a sort of firm grip,” says Stuart Phillips, a kinesiologist who studies muscle loss and aging in his lab at McMaster University in Hamilton, Ontario.

3.  You often feel drained and tired

If you feel more tired than usual, despite getting plenty of sleep and not being sick, that can also be a sign of emerging frailty, Nidadavolu says.

Doctors typically use short surveys to assess exhaustion, asking questions like whether you felt tired “all the time” or “most of the time” during the past month. They may also want to rule out other causes of fatigue like anemia, thyroid problems or nutritional deficiencies, Nidadavolu says.

But she says it often comes down to whether someone’s usual routine has changed. Maybe you used to fold laundry and then do the cooking, but now you are exhausted after just doing the laundry. Or perhaps you find yourself taking naps more often and skipping activities you usually enjoy.

4.  You’re slowing down

Are you walking more slowly than you used to? Does it take longer to get from the dining room to the kitchen? Those small changes matter.

When assessing frailty, doctors often measure gait speed. A common test is how long it takes you to walk 4 meters (about 13 feet). If it takes more than about 4 seconds, that may be an early sign of frailty, Varanasi says.

A slower gait speed is “highly predictive of someone who is at risk of developing frailty,” Nidadavolu says. “It can also be linked to overall mortality.”  

In a 2021 review of 85 studies, Italian researchers found that slower gait speeds predicted a range of health risks, including disability, long-term hospital stays and mortality.

5.  You’re not doing as much

Cutting back on activities you once enjoyed can be another early sign of frailty. Maybe you’re spending more time at home watching TV, or you’re just not feeling up to doing the hobbies and outings that used to be part of your routine.

“I have a lot of patients who love to play cards in the evening,” Nidadavolu says. “Sometimes that’s the first thing that starts slowing down.”

When exhaustion or weakness creep in, they can affect your activity level and set off a cycle: The less you do, the more muscle you lose — and the harder it becomes to stay active. But you can break that cycle, experts say.

How to stay strong and reverse early frailty

Here are some tips on how to prevent becoming frail

Frailty is reversible, especially in the early stages, Phillips says. You can also take steps to prevent it from developing in the first place. Here are some evidence-based ways to fight frailty:

Build strength

All types of exercise combat frailty — including aerobic activity and balance training — but “the biggest thing and the highest impact” type of exercise is resistance training to increase strength and muscle power, Phillips says. A 2021 meta-analysis found that resistance training boosted strength, speed and balance in older adults. Phillips says he has seen it make a difference even for people in their 80s and 90s. “They’re able to improve their ability to get up and get around,” he says. (The AARP 30-day Couch-to-Fit Challenge has dozens of strength-training videos.)

Prioritize protein

Adequate protein helps counter age-related muscle loss. Phillips recommends at least 1.2 grams of protein per kilogram of body weight per day; that’s 98 grams per day for a 180-pound adult. He’s not a big fan of traditional meal-replacement shakes, which usually list water and maltodextrin as their first ingredients. Instead, he suggests protein supplements, Greek yogurt, eggs and other whole-food sources. (AARP Members: Read 25 Great Ways to Get More Protein in Your Diet.)

Review your medications

Some drugs can cause fatigue, dizziness, confusion or appetite loss, which may worsen frailty. If you take multiple medications, they also may be interacting in ways you don’t realize.  Nidadavolu suggests talking to your pharmacist or physician about whether your symptoms could be caused by medication side effects or interactions.

Stay socially connected

Regular interaction with others, whether it’s playing cards or joining a class, helps keep your body and mind engaged. Social connection is a “protective factor” against frailty, Nidadavolu says.

Address barriers

Poor vision and hearing, depression and anxiety can all speed up frailty, and all are treatable. “If you can't hear, well, you're not going to socialize, right?” Varanasi says. If you can't see well, you might not feel comfortable driving and going places, she says, and you are at higher risk of a fall. Correcting hearing and vision loss can also help stave off dementia and Alzheimer’s disease.

Seek professional help

Early action can make a difference. If you’re concerned about yourself or someone you love, Varanasi and Nidadavolu suggest scheduling a visit with a health care provider who can evaluate for early signs of frailty. They can guide you toward changes that can improve your strength, energy and confidence.