Exercise and nutrition play a central role in the management of frailty in older adults by improving physical function, muscle strength, and overall health outcomes. Tailored exercise programmes focusing on strength, resistance, balance, and moderate-intensity activities such as walking, dancing, or swimming are recommended to maintain or improve mobility and reduce the risk of falls in frail older people NICE CG161,NICE. Strength and balance training, individually prescribed and monitored by trained professionals, is particularly effective in reducing fall rates and promoting independence NICE CG161,NICE CKS. Exercise interventions should be adapted to the preferences and abilities of older adults to enhance adherence and motivation NICE.
Nutrition management is equally critical, especially addressing malnutrition and ensuring adequate protein and energy intake to prevent or mitigate sarcopenia and muscle loss associated with frailty NICE CKS. Dietary advice should focus on increasing protein-rich meals and energy-dense foods without necessarily increasing food volume, considering individual clinical and social factors NICE CKS. Oral nutritional supplements (ONS) may be necessary when dietary intake alone is insufficient, as they have been shown to improve weight, muscle strength, functional outcomes, and reduce complications related to malnutrition NICE CKS.
Combining exercise and nutritional interventions is supported by both UK guidelines and recent geriatric literature as an effective multifactorial approach to managing frailty, aiming to preserve mobility, reduce falls, and improve quality of life NICE NG16,NICE CG161,NICE CKSDent et al. 2023Billot et al. 2020. Early identification and individualized care plans involving multidisciplinary teams are essential to optimize these interventions NICE NG16,NICE CKSWalston et al. 2018.
Key References
- NG16 - Dementia, disability and frailty in later life – mid-life approaches to delay or prevent onset
- CG161 - Falls in older people: assessing risk and prevention
- PH16 - Mental wellbeing in over 65s: occupational therapy and physical activity interventions
- CKS - Falls - risk assessment
- CKS - Adult malnutrition
- (Walston et al., 2018): Frailty Screening and Interventions: Considerations for Clinical Practice.
- (Billot et al., 2020): Preserving Mobility in Older Adults with Physical Frailty and Sarcopenia: Opportunities, Challenges, and Recommendations for Physical Activity Interventions.
- (Dent et al., 2023): Recent developments in frailty identification, management, risk factors and prevention: A narrative review of leading journals in geriatrics and gerontology.