SNAP SHOT
Tracking Frailty Through Everyday Activities
AS THIS ISSUE’ S Feature Focus describes, frailty is a condition of decreased biological reserve and resilience that can result in vulnerability to falls, hospitalization, disability, and mortality. Frailty is usually associated with aging. However, chronic disease, such as multiple sclerosis( MS), can speed up the onset and development of frailty. Frailty can be revealed through long-term changes in activities of daily living( ADLs), everyday tasks and events that require physical, mental, or social effort that most healthy individuals can perform without assistance. These activities include eating, dressing, bathing, toileting, managing continence, and mobility, essential measures of an individual’ s functional status.
People with MS commonly show frailty through a combination of fatigue, low levels of physical activity, unintentional weight loss, slow walking speed, and weakness( grip strength). The NARCOMS Registry provides a window into participants’ experience with frailty through the collection of longitudinal survey data. Changes in the ability to tackle ADLs over time can reveal the advance of frailty in participants. These data can, in turn, provide clues to triggers and events that promote frailty’ s progression.
In 2016 and 2025, a NARCOMS Survey question asked participants to identify their ability to perform nine ADLs.
These were 1) using a telephone, 2) local transportation, 3) grocery shopping, 4) preparing meals, 5) doing housework, 6) doing handyman work, 7) doing laundry, 8) taking medications, and 9) managing money. Answer choices were“ Need No Help,”“ Need Some Help,” and“ Unable to do at all.” Combining participant data to describe the trends in change over the 10-year period can highlight ADL challenges that MS may present. In addition, this data can be further investigated for influences of age, sex, MS type, or environment.
Figure 1 shows participant 10-year changes in six ADLs. Data are expressed as the percent of participants that experienced either Improvement, Stability, or Worsening in each ADL. A large percentage of participants showed improvement in Taking Medications and Managing Money. A possible explanation is that, over time, people with MS gain experience in tracking and adjusting medications, as well as monitoring financial status. Getting Around, Handyman Work, Household Work, and Grocery Shopping showed significant worsening. While these data do not assess frailty, they may be useful to anticipate development of frailty.
Figure 2 takes the data presented in Figure 1 and compares ADL changes between men and women. The data are expressed as the number of change responses
10 | NARCOMS. org