Physical frailty, sarcopenia, and the enablement of autonomy: philosophical issues in geriatric medicine

Physical frailty and loss of muscular mass (sarcopenia) are believed to be predictors of age-related conditions, such as disability and loss of autonomy. In this paper, I show that what in political and moral philosophy has come to be known as “the capability approach” may indeed provide much needed conceptual clarification in the area of frailty research. Other than being useful at the theoretical level, the capability approach can definitely help in the implementation of clinical guidelines and public health measures aimed at translating the results that are accumulating from frailty research. I will first briefly review the main philosophical tenets of the capability approach, and then analyze how they relate to current debates about frailty and sarcopenia by introducing the notion of “enablement”. Finally, I will show how my analysis bears on both clinical research in this domain and public policy aimed at tackling some of the age-related issues in an aging society.