Strength and Frailty

Personal functional independence is in large part determined by physical health. The strength (or weakness) of muscles, bones, joints, and the cardiovascular system define our capacity to move through our days and accomplish the normal daily activities of living. We view strength and frailty as opposite ends of the same spectrum and strive to find solutions to move individuals in the direction of strength. While exercise can help in this regard, it may at times be necessary to intervene in other ways ranging from pharmaceuticals to devices to other types of treatments.

In this area, the Center will initially focus on sarcopenia as a primary indicator of strength. Translated literally from Greek as “poverty of the flesh”, sarcopenia refers to age-related loss of muscle mass. While such loss is common in humans, the exact point at which it can be diagnosed as sarcopenia remains a topic for discussion. Regardless of this threshold, sarcopenia is a critical component, along with osteoporosis, of frailty syndrome. A 1991 study at the Palo Alto VA estimated that 27% of patients over age 65 were judged to be frail1. It has been estimated that the direct cost of sarcopenia to the U.S. in the year 2000 was $18.5 billion2.

The Center will also continue its work on osteoarthritis, which is estimated to affect nearly 27 million people in the United States alone.


1CH Winograd, MB Gerety, M Chung, Mary K. Goldstein, F Dominguez, R Vallone, Screening for Frailty Criteria and Predictors of Outcomes, Journal of the American Geriatric Society, 1991: 39:778-784

2Janssen, I., Shepard, D., Katzmarzyk, Roubenoff, R., The Healthcare Costs of Sarcopenia in the United States, Journal of the American Geriatric Society, 2003: 52: 80-85