In my first interview with my (now) mentor, I was asked “how would you describe frailty?” and me, being a highschool student at the time responded, “I think frailty refers to an individual being weak, loss of strength perhaps”. He smiled and acknowledged that I was on the right path.
Little did I know, I was only able to provide part of the answer. My knowledge was incomplete, perhaps because I was so naïve to the world of research and science.
Around the second year of university, I defined frailty from a physical activity standpoint, I assumed “frailty” only referred to the deficits in the physical/ physiological reserve of an individual and more commonly seen amongst older adults.
Yet again, I was only partly correct. But this time around I learned that physical frailty can be measured using validated tools such as the Short Physical Performance Battery (SPPB) test , and in the clinical settings, the Clinical Frailty Scale (CFS).
Recently, I learnt about social frailty. Simply put, I think social frailty can be described as the gradual decline in social connectedness in an individual’s life wherein factors such as financial status and leisure activities are significant contributors.
Questions such as: “What do you like doing in your leisure time?” can possibly tell us a lot about the social engagement aspect and may help understand social frailty.
When I started to read more papers on social frailty, I started to notice an overlap between cognitive frailty particularly cognitive reserve which can also be measured through the engagement in leisure activities and educational status amongst many other factors.
A debatable question is, “can you improve your cognitive reserve later in life or does life experiences only shape the cognitive reserve?”
These questions led me to learn about cognitive frailty. In the literature, cognitive frailty has been described as “the presence of both physical frailty and cognitive impairment” (Bu et al., 2020).
To think about this in a real-life context, would you think that an individual who is objectively identified as physically frail would also be socially frail and cognitively frail?
What links the 3 types of frailty? I think it is the individual’s engagement in physical activity.
References:
Bu, Z. H., Huang, A. L., Xue, M. T., Li, Q. Y., Bai, Y. M., & Xu, G. H. (2020). Cognitive frailty as a predictor of adverse outcomes among older adults: A systematic review and meta‐analysis. Brain and Behavior, 11(1), 1–14. https://doi.org/10.1002/brb3.1926
