In simple terms, ageing is an accumulation of cellular damage over time. Yet there is significant heterogeneity in the older population in terms of health status and care needs; some individuals remain functionally independent into their tenth decade whereas others have complex comorbidities and psychosocial problems from middle age. Frailty is a way to capture these differences in health status. While the pathophysiological pathways that lead to frailty are not well defined, an individual’s sex appears to be a key factor influencing the ageing trajectory. Compared with age-matched men, women tend to have poorer health status (ie, they are more frail) but longer life expectancy (ie, they are more resilient). This is one of the fundamental paradoxes of ageing.
This presentation will review the biological, social and behavioural factors for women’s longer life expectancy - and for their poorer health status. It will also explore the evidence base for interventions to reduce or mitigate frailty in old age. Randomised controlled trial data for frailty interventions in older adults are emerging, with multicomponent programs incorporating exercise and nutrition-based strategies showing promise. Pharmaceutical and other innovative therapeutic strategies for frailty are highly anticipated. In the future, for interventions to be most successful, they should target multiple biopsychosocial domains, and carefully consider issue relevant to each sex. Potential targets for the prevention and treatment of frailty in older women will be considered in terms of their evidence base and potential feasibility.