Frailty and Falls Prevention Research

Frailty and falls: where human trial evidence is strongest

Frailty and falls are among the aging topics with a solid body of human trials, using outcomes people care about: falls, strength and walking. This page summarizes research. For practical everyday steps see Frailty and Falls and Balance. Nothing here is personal medical advice.

Evidence labels: established, promising but limited, mixed, no good evidence of benefit.

What frailty means

Frailty is described as a state of vulnerability to poor recovery after a stressor such as an illness, resulting from the buildup of declines in many body systems over a lifetime. [1] It is not the same as being old, or as having a disability or other illness. In the 2001 Cardiovascular Health Study, which followed 5,317 people aged 65 and older, frailty was defined as three or more of: unintentional weight loss, self-reported exhaustion, weakness (grip strength), slow walking and low physical activity. About 6.9% were frail, and frailty predicted falls, worse mobility, hospitalization and death over three years. [2]

There is no single agreed definition. Another approach, the Frailty Index, counts accumulated health deficits, and reviewers note that multiple definitions and measures cause confusion. [3] A frailty score is a risk marker, not a diagnosis of a disease. See Sarcopenia and Muscle Loss for the related muscle condition.

How common falls are

The National Institute on Aging reports that more than one in four people 65 and older fall each year. [4] The NHS notes anyone can fall but it is more likely if you are older or have mobility problems. [5] The NIA lists risk factors including weak muscles, balance problems, blood pressure drops on standing, foot problems, some medicines, and vision or hearing changes. [4]

What the trials show

Details to keep in mind: most trials in the 2019 review had unclear or high risk of bias on at least one item, and effects on fractures and other outcomes were less certain, though exercise may reduce fall-related fractures (risk ratio 0.73). [6] Adverse events in exercise trials were mostly non-serious. [6] The 2012 review was older than the exercise one, and newer trials exist that we did not review for this page, so its multifactorial and vitamin D findings should be read as of that date. The US Preventive Services Task Force recommends exercise programs to prevent falls for community-dwelling adults 65 and older at increased risk. [9] See also Yoga Evidence by Outcome and Tai Chi.

Longevity angle

Nothing here supports a claim that a supplement or compound prevents frailty. Frailty trials have tested exercise, not anti-aging products. For longevity interventions see Longevity Interventions: What Human Evidence Exists. Bone consequences of falls are covered in Bone Health, Osteoporosis and Aging.