Dedicated to Change in the Delivery of Health Care

Age-related Weakness

As we age weakness sneaks up on us. We become more fatigued and tired with activities that were done easily in the past. If allowed to progress, weakness leads to frailty. Frailty leads to falls with bone fractures, decreased quality of life, increasing dependency and premature death. If suffering from a chronic disease the effects of frailty magnify any impairment attributed to the disease itself.

There is a simple way to test yourself to see if you are frail. Can you get up from a chair without using your hands or the chair armrests? Try it. Use a kitchen or dining room chair.

If you cannot "pass" the test you need to take steps to decrease your risks from frailty.

Start by walking regularly 3 to 5 times every week. Work up to a 15 to 30 minute walk each time. Walking works best if done with others - persons or a pet. Even better is walking up stairs. Walking up stairs strengthens thigh muscles that help maintain balance. Good balance prevents falls.

As we age we accumulate prescription medication. Many medications taken by elder persons contribute to weakness, dizziness and impaired alertness than can lead to falling and injury. Among these: antidepressants, medications taken for chronic pain such as gabapentin (brand name Neurontin) and pregabalin (brand name Lyrica), statins to lower cholesterol (Lipitor, Zocor and others) and prevent a heart attack or stroke in persons who have never either of these, sleeping pills which can interfere with cognitive performance and attentiveness that increase the risk of a fall. The risk of fall and injury due to weakness may outweigh the marginal benefit of medication with risky side effects. Talk to your doctor to find safer alternatives.

Most older Americans are vitamin D deficient. Vitamin D supplementation improves strength and decreases arthritic pain. The minimum daily dose needed is 1000 units. Vitamin D is safe unless you have advanced kidney disease or a problem with high blood calcium. Talk with your doctor to see if a vitamin D supplement of at least 1000 units daily is safe for you.

Iron is an essential mineral (meaning it can only be gotten from food or a supplement) that is important for DNA repair, blood formation and muscle function, i.e. strength and mobility. Absorption of iron from food requires stomach acid. A common prescription medication used by many are called proton pump inhibitors (PPI) or stomach acid blockers- Prilosec, Nexium, Prevacid, Acjphex, Protonix to name a few brands. The prescription - like those for cholesterol, anxiety, sleep, and depression - seems to take on a life of its own and be refilled by your doctor forever. When you become anemic for lack of iron, your doctor will likely prescribe an iron supplement, which can upset your stomach (reinforcing the need for the PPI) and cause constipation. The better course of action is to stop the PPI. Stomach acid is also important for absorbing other nutrients from food and for absorbing some medications.

The bottom line: if you have been taking a medication for years to treat a non-life threatening and non-progressive problem(s) or just symptoms without disease, you should seriously consider stopping those medications. There is no harm in seeing what happens without them.

Back to Lessons

patient centered care

Only patient centered care will lead to quality and cost effective care.