March 17, 2023
SINGAPORE – Frailty among older people within the community is expected to grow markedly from 5 to 6 per cent now to 27 per cent in 2030 as Singapore’s population ages.
While the sharp increase in cases, based on a 2019 study by Tan Tock Seng Hospital (TTSH), may seem alarming, it does not spell the end for the feeble elderly.
In fact, frailty can be reversed and that is good news for both doctors and seniors.
Dr Jerome Goh, clinical director of the division for central health at TTSH, said: “What worries us is that 10 per cent of those above 65 years have mild to moderate frailty, while 5 per cent have severe frailty.
“That is why we have to do something about it before the costs of their medical care soar.”
Frailty is a medical condition of reduced function and health in older individuals.
Factors such as inactivity, poor nutrition, social isolation and multiple medications can contribute to frailty.
When an older adult is frail, minor stressors may trigger rapid and dramatic deterioration.
Preventing, delaying and reversing frailty
According to Dr Goh, frailty also drives up medical costs because someone who is severely frail has to pay five times as much as a patient with chronic disease such as diabetes.
“This is why there is a need to intervene early. The silver lining here is frailty can be reversed,” he said.
Studies, both in Singapore and overseas, have shown that physical exercise, a change in diet, cognitive training and even a combination of the three can help prevent, delay and even reverse frailty among the elderly.
Physical activities like walking and easy strength-training moves improve strength, and the frail elderly also need three healthy meals a day that include fruit, vegetables, protein, good fats, whole grains and low-fat dairy products.
Playing mahjong and talking to friends can also help prevent the onset of frailty.
“Mental intervention also helps with balance,” said Dr Goh, a trained psychiatrist.
As TTSH takes care of the population in the central zone, its doctors work with community partners Comnet Senior Service and Chong Hua Tong Senior Activity Centre to identify residents in the community who are at moderate to high risk of developing frailty, and come up with programmes to prevent and delay frailty and falls.
The team started the work in October 2022 and managed to screen 334 of the 175,400 seniors above 65 years old living in the central zone by January 2023.
From this number, it was found that 11 per cent fall under the high-risk category and 39 per cent in the moderate range for frailty.
Mr Simon-Peter Lum, who heads Comnet Senior Service of the Ang Mo Kio Family Service Centre Community Services, said this means his staff and the community nurses need to work a little harder to have the seniors understand that frailty can be reversed.
Retiree Agnes Ong and housewife Jumaiah Samian, both 80, have been converted.
They encourage each other to walk daily to reverse their osteoarthritis.
“It’s the first time in my 80 years that I am living alone and if it wasn’t for Jumaiah, I doubt I’d be able to exercise because of my knees,” Madam Ong said.