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Staying Strong And Healthy As You Age

American Heart Association

Why It Matters:

  • Getting older can mean getting weaker and becoming more susceptible to injury. 
  • Frailty can lead to loss of independence and premature illness.
  • Doctors are investigating ways to prevent frailty by preserving strength.


As people age, resilience dwindles, and their bodies become more vulnerable to illness.

But many aren’t aware that this is a syndrome called frailty, and chronic illnesses such as heart disease can cause frailty in younger people, too. Frailty occurs when there are declines in function across body systems, leading to increased risk for serious health events.1

Doctors are working to discover new ways to postpone or avoid it all together. Watch this short video to learn ways to stay strong and healthy at any age.

Now let’s take a deeper dive into what frailty entails, how to recognize it, and potential strategies to prevent it.

What is frailty?

“There are two definitions of frailty,” said Barbara Nicklas, professor of gerontology and geriatric medicine at Wake Forest Medical School in North Carolina. One is when several body systems are functioning poorly. “Another is more about physical operation: low grip strength or muscle weakness, slow gait speed, a tendency to have lost weight, and a strong feeling of fatigue. One is how a person feels and performs, and another is how sick a person is.”

About half the population 85 and older experiences frailty, Nicklas said.

Warning signs and causes

Early signs include unintentional weight loss of 10 or more pounds in one year and taking six or seven seconds to walk 15 feet, according to Johns Hopkins Medicine.2

It sometimes goes hand-in-hand with sarcopenia, which is the loss of muscle mass and strength that tends to happen more quickly after the age of 50. According to a 2019 study,3 sarcopenia can be a significant contributor to frailty.

But frailty and sarcopenia don’t exclusively affect the elderly, said Dr. Daniel Forman, a geriatric cardiologist at University of Pittsburgh Medical Center in Pennsylvania. Frailty becomes more common as you age, but inflammation, along with hormonal changes, can speed the onset.

“It can happen at different times of your life,” he said. “Most cardiologists would think that it’s a biological thing and it overlaps directly with cardiac disease. With heart failure, frailty can come in much earlier than old age.”

Many studies have examined the link between heart disease and frailty. According to a 2018 review, up to 79% of patients with heart failure are frail.4

A similar observation has been made about sarcopenia and heart disease. Sarcopenia was reported in 5-13% of people 60- to 70-years-old, while it was reported about 20% more in patients with chronic heart failure than healthy subjects of the same age.5

Frailty has a notable impact on healthcare costs as well. According to a 2018 study conducted to analyze the effect of frailty on the resource use and cost for Medicare patients, frailty increased the average cost of medical care by as much as $17,220 in a nine-month period.6

Potential strategies for prevention

While doctors are searching for ways to prevent frailty and sarcopenia, “No one knows exactly how to avoid it,” Forman said. “That’s the million-dollar question.”

“But diet and exercise seem to be part of the puzzle,” Nicklas said. “It’s particularly important to get enough protein and vitamin D as we age.”

“The biggest prevention is physical activity, especially strength training or resistance training,” Nicklas said. “Maintaining a healthy weight is also important, especially in middle age. People who are overweight have a higher propensity for becoming frail.”

Johns Hopkins Medicine recommends eating three meals each day that consist of fruits, vegetables, healthy fats, whole grains, and low-fat dairy products.

For example, following the Mediterranean diet, which consists of olive oil, nuts, whole grains, and seafood, with moderate amounts of low-fat yogurt, low-fat cheese, and poultry, can help preserve strength.7

Some researchers are also examining the effects of intermittent fasting ― the practice of alternating cycles of fasting and eating, sometimes waiting until the end of the day to eat ― on frailty.8

“There is no sure-fire solution for all people,” Forman said. “It is complicated, and it is still under investigation.”


Things to Consider:

  • Following a healthy diet can provide nutrients that help maintain strength.
  • Exercise can make you less vulnerable to frailty as you age.
  • Maintaining a healthy weight is a key component of staving off weakness and illness.


1 “Frailty Screening and Interventions: Considerations for Clinical Practice,” Jeremy Walston, Brian Buta, and Qian-Li Xue, 2019

2 “Stay Strong: Four Ways to Beat the Frailty Risk ,” Johns Hopkins Medicine, 2019

3 “Osteoporosis and Sarcopenia Increase Frailty Syndrome in the Elderly,” Emanuela A. Greco, Peter Pietschmann, and Silvia Migliaccio, 2019

4 “Frailty in Heart Failure: Implications for Management,” Cristiana Vitale, Ilaria Spoletini, and Giuseppe MC Rosano, 2018

5“Muscle Wasting and Sarcopenia in Heart Failure and Beyond: Update 2017,” Jochen Springer, Joshua‐I. Springer, and Stefan D. Anker, 2017

6 “Effect of Frailty on Resource Use and Cost for Medicare Patients,” Kit N. Simpson, Bryant A. Seamon, Brittany N. Hand, 2018

7 “Stay Strong: Four Ways to Beat the Frailty Risk ,” Johns Hopkins Medicine, 2019

8 “What Is Intermittent Fasting? Explained in Human Terms,” Healthline, 2017


This article was prepared by the American Heart Association (AHA). Transamerica is not affiliated with the AHA and does not control, guarantee, or endorse the information. This information does not constitute the practice of medical advice, diagnosis or treatment.

Transamerica Resources, Inc. is an Aegon company and is affiliated with various companies which include, but are not limited to, insurance companies and broker dealers. Transamerica Resources, Inc. does not offer insurance products or securities. The information provided is for educational purposes only and should not be construed as insurance, securities, ERISA, tax, investment, legal, medical or financial advice or guidance. Please consult your personal independent professionals for answers to your specific questions.