Our family has gotten together every other year for over twenty years — until COVID.   Luckily, there was a recent wedding that brought us all together; I hadn’t seen some of my older relatives in five years. Even as a geriatrician, I haven’t really thought about my own family members aging. (Aside from me…I’m very aware of my own aging!)

This year was different. COVID has been horrible for elders, causing more strokes, heart attacks, dementia, and death in those over 70. So, after a few cases of COVID, various other illnesses, surgeries, and the passage of time…the hearty laughs and quick wit were softer.  Thankfully, none had declined to the point of dementia, but a few of my family members were noticeably more frail.

My 90 year-old dad is still spry, which a mischievous twinkle in his eye as he tells a story or a joke.  He and his wife have worked hard to keep up biking, walking, tennis, and eating a mostly plant-based diet that I credit for his energy and strength.

But what is frailty?  It’s somewhat hard to define, but like they say about pornography, geriatricians know frailty when they see it.

An elder can test normally but still walk slower, speak more softly, lose weight, get tired more easily from loss of muscle mass, take longer to bounce back from illness or surgery, or they may lose function to the point that they can’t walk, can’t drive, or they need daily care. Elders lose five percent of their muscle mass for each day they stay in bed.

Even catching up with a college friend after not seeing him for four years, I was alarmed at his weight loss and slower movement. I gently recommended that he see his doctor.

So, have a great time with family. Be aware that COVID is still with us and more dangerous to elders. Best to have gatherings outdoors, if possible, or with windows open for ventilation. Everyone should get boosters and anyone sick should stay home. If elders are present, I’d advise that everyone check their COVID status with a home test prior to big family gatherings.

You should also watch out for changes. The best way to deal with the decline we’ll all face at some point is to be aware, and come up with a plan to assure safety and support. Get evaluated by your doctor for new symptoms, eat a good diet, and keep moving. Exercise and eating enough protein are some of the best ways to prevent frailty.

And most importantly, spend time with the people you love.

Happy Thanksgiving.