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FRAILTY CAN SNEAK up on you gradually in the form of a slower walk, tiring more easily, or needing to hold on when getting up from your favorite chair. And it’ s more serious than it sounds.
“ Frailty is a medical syndrome characterized by decreased physiological reserve and resilience,” Tobia Zanotto, PhD, told NARCOMS Now. Dr. Zanotto is an Assistant Professor in the Department of Occupational Therapy Education at the University of Kansas Medical Center. His research focuses on improving mobility and preventing adverse clinical outcomes in people with frailty or chronic diseases.
“ In practical terms, it means that the body becomes less able to cope with stressors such as illness, injury, infections, surgery, or even everyday challenges,” he explained.“ Frail individuals are therefore more vulnerable to adverse outcomes, including falls, hospitalization, disability, and mortality. Historically, frailty has been viewed as a condition affecting older adults. However, we now know that frailty can develop much earlier in people living with chronic diseases, including MS.”
MS, FRAILTY, AND COMORBIDITIES
Research suggests that the percentage of frailty in people with MS aged 40 to 65 years is two to four times higher than in people without MS over age 65. 1 In 2024, a literature review found that frailty in people with MS is associated with greater disability, longer disease duration, and progressive MS. 2 Study authors wrote that“ frailty may represent an underinvestigated clinical realm in the MS community.”
People often think of frailty as physical weakness, but in MS, it commonly involves a combination of fatigue, low levels of physical activity, reduced mobility, muscle weakness, cognitive difficulties, and mental health challenges, according to Dr. Zanotto.
While it’ s more common among people with progressive forms, he noted that many people with relapsing-remitting MS meet objective criteria for frailty, often at relatively young ages.
For people with MS, the line between neurological disability and frailty can be somewhat blurry.
“ Frailty is accelerated aging, and aspects of MS look like accelerated aging,” Kenneth Rockwood, MD, MPA, FRCPC, told NARCOMS Now. Dr. Rockwood, a leading expert on frailty, is a staff physician and Professor of Medicine( Division of Geriatric Medicine and Neurology) and Clinical Research Professor of Frailty and Aging at Dalhousie University in Nova Scotia.“ As people age, they’ re more likely to accumulate health deficits,”
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