What will you encounter when you are getting older? You will experience the great magnitude of physical and mental health changes resulting from the aging process, the transition from healthy status to increased frailty and vulnerability.
Frailty is one of the common geriatric syndromes (CGS). It is relatively high in those living in the community that makes long-term adverse outcomes to the older adults, including multiple falls, disability, comorbidity, and mortality, affecting to a lower level of quality of life (Royal College of Nursing [RCN], 2021; Srinonprasert et al., 2018).
Previous studies of Thai community-dwelling older adults indicated the prevalence of frailty reaching 22.1%. Male older adults were more at risk of mortality, mortality rate 48.8 per 1,000 in those with frail condition vs 21.5 in those without frail condition (Srinonprasert et al., 2018). During the unprecedented covid-19 pandemic, the spread of covid-19 highly affected older adults, especially health status. United Nations Fund for Population Activities in Thailand (UNFPA, 2020) reported 20% of Thai older adults felt their health status worsened. It was significantly higher in the urban areas than the rural areas. 8% of older adults reported their health problems further exacerbated during the pandemic due to missed medical appointments.
Individuals, communities, local administration organizations, and the private sectors can promote a healthy aging community and reduce the burdens of being frail, specifically during the pandemic. Recommendations to promote a healthy aging community are:
- Community outreach: Local administration organizations, health professionals, and community health care centers (Subdistrict Health Promotion Hospitals) should take more responsibility for health promotion and disease prevention for older adults in the communities. They should work with municipal officers, village leaders, and health volunteers to regularly visit older adults and provide a primary health screening for those who are at risk of frailty, such as fall-risk screening. Covid-19 prevention measures, i.e., social distancing, wearing a mask, and washing hands should be strictly done (Huang et al., 2017; Ministry of Public Health, 2018).
- New normal health promotion activity: Health professionals, local administration organizations, and the private sectors such as internet service provider companies should establish online exercise clubs which encourage older adults to exercise to reduce the burdens of frailty, such as fall injury, promote health, and prevent diseases. Internet providers should extend access to affordable high-speed internet for older adults. For the type of exercise, Tai Chi is an exercise suitable to older adults and could prevent fall injury and promote physical fitness (Huang et al., 2017). The health services should be accessible by multiple platforms, including mobile applications and televisions.
- Telehealth medicine: As older adults with chronic conditions need follow-up services, the pandemic is an opportunity in which health professionals, institutions, technology companies, and governmental organizations develop a technology-based medicine, including online meeting, visual reality (VR), and artificial intelligence (AI) to assist health services. For example, the number of gerontologists in Thailand is limited. However, we can use the technologies mentioned earlier to expand access for older adults living in remote communities. Thus, those with chronic health conditions, such as hypertension, chronic kidney disease, and diabetes mellitus, can follow-up or consult for their health concerns.
As older adults are vulnerable, being more senior with a healthy condition during the pandemic is a challenge for the policymakers and the stakeholders to determine and implement actions to keep a healthy aging community. How could we prevent the adverse outcomes from frailty and promote physical and mental health during one of the most challenging times?
by Pornthip Suyasith, MNS, RN1,2
1Lecturer, Faculty of Nursing, Mahidol University, Thailand, 2PhD student, College of Nursing and Health Sciences, University of Massachusetts Boston, USA
References
- American Association of Retired Persons. (2021). The 8 domains of livability and COVID-19.
- Huang, Z. G., Feng, Y. H., Li, Y. H., & Lv, C. S. (2017). Systematic review and meta-analysis: Tai Chi for preventing falls in older adults. BMJ Open, 7(2),
- Ministry of Public Health. (2018). Twenty-year national strategic plan for public health.
- Royal College of Nursing. (2021). Frailty in older people.
- Srinonprasert, V., Chalermsri, C., & Aekplakorn, W. (2018). Frailty index to predict all-cause mortality in Thai community-dwelling older population: A result from a National Health Examination Survey cohort. Archives of gerontology and geriatrics, 77, 124–128.
- United Nations Fund for Population Activities. (2020). The impact of COVID 19 on older persons in Thailand – Evidence from the survey.
