December 19, 2013 —“The diseases of aging are not inevitable,” geriatrician Linda Fried told a Harvard School of Public Health audience on December 16, 2013. As people live longer around the world—largely due to successes in public health over the past century—understanding the science of healthy aging is imperative, she said. Fried, the Dean of Columbia University’s Mailman School of Public Health, delivered the first in a new Centennial Women Leaders in Public Health lecture series organized by the Committee for Advancement of Women Faculty.
People’s health varies widely as they age, Fried said. While some 80-year-olds walk slowly and with difficulty, others remain robustly active. Some elderly adults are able to bounce back from a stressful event such as a hospitalization, while others are thrown into a spiral of increasingly poor health.
Research by Fried and others has provided evidence for the idea that frailty in older adults should be considered a clinical syndrome defined as an “increased state of vulnerability of developing dependency and mortality, particularly following a stressor.” Geriatric health experts at a recent conference recommended that all adults over 70 be screened for the symptoms of frailty, Fried said. These include weight loss, weakness, exhaustion, slowed walking speed, and low activity.
Through her work with several long-running studies, Fried has found that adults over age 70 with at least three symptoms of frailty demonstrated sharper spikes in blood sugar after being administered glucose, increased muscle recovery time from minimal exercise, and a decreased immune response to the flu shot, as compared to those who were not frail. Frailty also is associated with inflammation, altered hormone levels, and nutrient deficiencies, she said.
This has led her to the conclusion that frailty is a result of disregulation in the systems that “maintain a resilient and robust human organism.” More work is needed to understand what drives these systems to break down. Lifestyle factors such as smoking, inactivity, and low protein intake have been shown to predict frailty, and there may also be core mitochondrial and epigenetic drivers, she said.
HSPH Dean Julio Frenk introduced Fried, and praised her efforts to promote gender equity in academic institutions, which he called a top priority at HSPH. The event was co-sponsored by the University’s Office of the Senior Vice Provost for Faculty Development and Diversity.
Photos: Emily Cuccarese