Aging Without Frailty – A Series
Fred Bartlit really lit me up!!
Fred’s story showed up in a recent Sunday issue of our local newspaper. My wife found it, brought it to me and said: “This guy is singing your song!”.
She was absolutely right. Fred is an 86-year old West Point grad, former Army Ranger, founder and practicing attorney in a hugely successful law firm, back-bowl skier, a golfer who shoots his age in summer, and a strength-trainer extraordinaire.
All that is impressive and inspiring in its own right, but what lit me up most is Fred’s vigorous campaign against one of the most damaging myths of aging that we allow to penetrate our psyche.
That myth? That we are all destined to get frail as we get old. To that, Fred says “horsefeathers” – or a more pejorative version of the word. He’s chosen to walk his talk.
He’s taking his message to the masses, not only by example but by speaking out publicly and co-authoring a book “Choosing the StrongPath: Reversing the Downward Spiral of Aging”. He’s not shy about holding our healthcare industry responsible for perpetuating the myth through their inaction and not educating patients on the ways to avoid early and long-term frailty.
Our two greatest fears
Research has shown that the two greatest fears we face as we age are:
- Fear of outliving our money.
- Fear of losing our independence
Frailty is how we lose our independence.
But what is frailty?
Six years ago, I stumbled into a book entitled “Dare to Be 100”, one of seven books written by Dr. Walter Bortz, 88-year-old retired Stanford geriatric physician and one of my heroes in this battle against the mythical stigmas of aging. Dr. Bortz put frailty into perspective for me and helped me make some needed changes in my lifestyle.
Dr. Bortz points out that frailty has lacked a conceptual framework. He poses interesting questions like:
- Is frailty a disease? Is so, where do we look for it in our medical classroom or textbooks?
- Is it a legitimate entry on a death certificate? Cause of death: he/she was frail. Not gonna happen.
- Can we admit someone to a hospital with the diagnosis of frailty and have a prayer of insurance covering anything?
- Is frailty aging? One would tend to think so since it shows up mostly with older people. But, at the same time, we can identify younger people who are frail due to any number of causes. If I put my leg in a cast for six months, it becomes frail.
So his position is that frailty is NOT synonymous with aging. Rather, “it is the reciprocal of vitality, robustness, and healthiness. It is a predisposition to failure. It is a disconnectedness, a weakness, an infirmity.” So an 86-year old Fred Bartlit can be totally unfrail while your 57-year old neighbor can be near totally frail.
More explicitly, and more profoundly, Dr. Bortz goes on to say:
“—frailty is a downward drift of matter from a more highly organized state of order, structure, and function to a state of increased disorder, instability, and susceptibility. The cause of this total decay is the loss of contact of the system from its environment, with its ordering capacity.”
Did I lose you there? Sorry. He finally drops the formal classroom jargon and says bluntly: “Frailty is not aging. Frailty results from disuse – even more than it does from aging. It is not a disease. It is a condition.”
And it’s reversible – NO MATTER THE AGE!
Dr. Bortz helped me understand that a body, or an organ within it, reaches clinical frailty when it reaches 70% loss of functionality. Falling below that 30% threshold is almost certain death of the organ or the body.
We have a “health space” with 70% to work with. Graphically, it would look like the graph below. Our mission should be to stay as high in the 70% space for as long as we can. We have much we can do to make that happen, far much more than we are showing the drive to do in our culture.
I’ve borrowed another one of Dr. Bortz’s graphs to illustrate further how frailty works if intervention doesn’t take place. If we just let life take its sedentary, convenience and comfort-seeking way without the intervention of proper diet and exercise, we are going to decline at a rate of about 2% /year after age 30, which is when our bodily decline begins to accelerate. By 65 or 70, at that rate, we are in trouble.
On the other hand, if we were to “intervene” with appropriate health-inducing activities and reduced that decline rate to, say, 1% or 0.5%, perhaps that 100 year threshold I profess would easily be in reach – at least theoretically, notwithstanding the possibility of some form of disease or event that changes that decline rate.
And that’s where Fred Bartlit comes into the picture. I haven’t spoken with Fred but I think he would agree with all this. I’ve asked for the opportunity to interview him so I can feature him in a future personal-interest article, but I suspect he is too busy to bother with that right now. Regardless, Fred and I are very much on the same wavelength – and mission – in terms of crusading for the avoidance and/or reversal of frailty.
I have witnessed too many friends, relatives, neighbors – as I’m sure you have – who are stooped, immobile and old before their time. Some may be disease related, but most of it is due to inactivity.
There is a rampant, but undiscussed, condition with a big, scary-sounding name associated with that. It’s called “sarcopenia”. Fred is on a campaign against sarcopenia – as I am. Because it doesn’t have to develop – and it is reversible.
I’m going to dedicate next week’s article to fleshing out and flushing out sarcopenia. Because somebody needs to – our medical community isn’t.
Stayed tuned – hang with me next week.
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