Prevention of Body Weakness in the Elderly

Introduction

Body weakness is a common complaint of old people. It can be associated with several geriatric syndromes, including frailty, sarcopenia (loss of muscle mass and strength), functional decline, failure to thrive, frequent falls, incontinence, and inability to ambulate. Weakness may develop suddenly or gradually and can affect all the muscles of the body or only one part of the body. Symptoms depend on which muscles are affected. Abnormalities in sensation, like tingling, a pins-and-needles sensation, and sometimes numbness, often accompany weakness. As people age, muscle tissue and muscle strength also decrease. These changes often occur partly because older people become less active with time and also because the hormone production that stimulates muscle development also decreases.

What Are the Features of Old Age Associated With Body Weakness?

The following symptoms are associated with body weakness in old age-

• Decrease in muscle mass.

• Increase in muscle fat.

• Decreased appetite.

• Poor nutrition.

• Low physical activity.

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• Incontinence.

• Recurrent falls.

• Low cholesterol levels.

• Slow gait speed.

• Poor endurance.

• Increased risk of infection.

• Weak grip strength.

• Change in cognition.

• Weight loss.

• Comorbidities.

What Are the Causes of Body Weakness in Old Age?

The cause of body weakness in old age are described below-

1. Failure to Thrive - Adult failure to thrive is defined as weight loss greater than five percent of baseline, decreased appetite, poor nutrition, and low cholesterol levels. It is often associated with increased infection rates, diminished cell-mediated immunity, hip fractures, decubitus ulcers, and increased surgical mortality rate. Failure to thrive is found in thirty-five percent of community-dwelling older adults, twenty to forty percent of nursing home residents, and fifty to sixty percent of hospitalized veterans. In patients with failure to thrive, malnutrition, impaired function, cognitive impairment, and depression are all predictive of adverse events. Many of these features are also associated with frailty and functional decline.

2. Sarcopenia - Sarcopenia is defined as an age-associated loss of skeletal muscle mass and function caused by inflammation, chronic diseases, disuse, altered endocrine function, insulin resistance, and nutritional deficiencies. The initial symptoms of sarcopenia are often associated with a decline in strength, function, and health status with self-reported mobility-related difficulty, history of recurrent falls, unintentional weight loss of greater than five percent, post-hospitalization, and chronic medical conditions. The prevalence is approximately twelve percent for patients 60 to 70 years of age and thirty percent for those over 80 years.

3. Geriatric Syndrome - Geriatric syndromes are terms used to capture clinical conditions in older persons that do not fit discrete disease categories. These include falls, delirium, frailty, dizziness, syncope, pressure ulcers, urinary incontinence, and functional decline. These syndromes are preventable, multifactorial, and associated with morbidity and poor outcomes. These syndromes have several shared risk factors, including baseline cognitive impairment, functional impairment, impaired mobility, and older age.

4. Falls - Falls are the leading cause of unintentional injury and the 6th highest cause of death among the elderly. Falls occur in thirty percent of adults over 65 years and forty percent over 80 years and lead to functional decline, hospitalization, institutionalization, and increased health care costs. Falls are commonly associated with severe injury, and even those whose injuries allow them to return home are at high risk for functional decline.

5. Frailty - Frailty is defined as the shrinking or unintentional weight loss with weak grip strength and poor endurance and energy as self-reported exhaustion. Risk factors for frailty include congestive heart failure, history of myocardial infarction, diabetes, hypertension, depression, chronic obstructive pulmonary disease (COPD), silent strokes, and subclinical atherosclerotic disease.

How Body Weakness Is Evaluated by Testing?

First, a thorough physical examination and history of current and past medical conditions will be performed by a doctor. If the weakness does not subside by maintaining lifestyle remedies, a doctor may perform certain tests to determine the cause of weakness, which include-

• Pulmonary function tests can be performed to evaluate the strength of the respiratory muscles. The results of this test can help doctors estimate the risk of sudden and severe malfunction of the lungs.

• MRI (magnetic resonance imaging) or CT (computed tomography) scan to find any spinal cord, nerve, or brain disorder.

• Blood tests to determine any vitamin deficiencies or blood-related disorders.

How to Prevent Body Weakness in Older People?

The first step in the management of body weakness of older patients is to identify the underlying cause and treat it.

• A well-maintained diet should include proper nutrients, fibers, and essential fats that can help strengthen the body.

• It is a common misconception that an older person should not perform exercises, but on the contrary, doing lightweight exercises can help maintain physical strength and enable the person to perform their daily activities efficiently. A regular walk, jogging, and even doing daily household chores can contribute to needed physical activity.

• Older people are often associated with comorbidities and the main cause of body weakness. Hence treating them with medical assistance is necessary.

• Vitamin supplements or other dietary supplements can be taken to help strengthen the body but only as prescribed by a doctor.

• Proper bed rest is important, as well as maintaining the sleep cycle.

• An older person can seek physical therapy to treat their body weakness.

• One of the major causes of body weakness in older people is the medications that they take for their comorbidities. Older people take more medicines and are also susceptible to the side effects of those medicines. Hence, early prevention of diseases and maintaining a healthy lifestyle can prevent people from using several medications.

Conclusion

Compared with younger people, older people present with less muscle tissue and strength at the initiation of the illness and lose the muscle tissue more rapidly during the illness. Body weakness is a chief complaint among the older population and requires an extensive evaluation to treat the cause. When evaluating any older patient, one must always consider their functional status and goals of care and also focus on conditions that do not tend to cause weakness but can interfere with coordination, balance, vision, and mobility or that can make movement painful as older patients can mistakenly describe the effects of such conditions as a weakness. A proper diet and exercise are the key factors in managing body weakness in old age, which can be caused due to several factors.