A recent international study (CRATUS Phase IIb trial) published in Cell Stem Cell has shown that mesenchymal stem cell therapy (Lomecel-B/laromestrocel) significantly improves physical endurance in elderly individuals with frailty.
- Researchers studying elderly individuals with frailty found that a single infusion of mesenchymal stem cells significantly improved their physical endurance.
- Participants aged 70 to 85 years who received the highest dose walked on average 60 m farther in a six-minute walk test nine months after treatment, which is a nearly 20% improvement over their baseline performance.
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About Mesenchymal Stem Cells
- Mesenchymal stem cells are naturally found in bone marrow and fat tissue.
- These cells are biologically versatile as they can differentiate into bone, cartilage or muscle and release molecules into the bloodstream that reduce inflammation and promote tissue repair.
- Unlike many cell therapies, mesenchymal stem cells do not strongly activate the recipient’s immune system, thus reducing the need for immunosuppressive drugs.
How Stem Cell Therapy Helps in Frailty?
- Restores Regenerative Capacity: Stem cells replenish the body’s declining repair mechanisms, helping regenerate damaged tissues such as muscles and bones.
- Reduces Chronic Inflammation: Mesenchymal stem cells release anti-inflammatory molecules, thereby countering “inflammaging” (chronic low-grade inflammation seen in ageing).
- Improves Muscle Strength and Endurance: By promoting muscle repair and growth, stem-cell therapy enhances physical performance (e.g., improved walking ability in elderly patients).
- Enhances Immune Function: Stem cells modulate immune responses, reducing vulnerability to infections and improving overall resilience.
- Promotes Tissue Repair and Healing: Through secretion of growth factors, stem cells accelerate healing of injuries and recovery after illness or surgery.
- Improves Vascular Health: They support repair of blood vessels, improving circulation and reducing age-related vascular decline.
- Increases Functional Independence By improving strength, endurance, and recovery, therapy helps elderly individuals maintain independence and quality of life.
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About Frailty
- Frailty is a state of accelerated biological ageing marked by lower endurance and slower recovery.
- For Example: An elderly person suffering from frailty taking unusually long to recover from a minor fall or infection is often experiencing frailty rather than just “normal ageing.”
- Cause: It is not a single disease with a single cause, rather it arises from the cumulative effects of chronic inflammation, muscle loss, vascular ageing, immune dysfunction, and long-term stress.
- Impact: Frailty affects up to one in four people over the age of 50 worldwide.
- In India, where the population aged 60 and over is projected to rise to nearly 20% by 2050, the condition is likely widespread but rarely diagnosed.
Challenges of Frailty
- Mechanism of action not fully understood: Unlike diseases such as diabetes or hypertension, frailty has no standard treatment protocol as well as is under-visible in policy.
- Health System Oriented Towards Acute Care: India’s health system is still largely oriented towards acute illness rather than chronic ageing.
- Frailty is a strong predictor of hospitalisation and mortality but rarely features in clinical records or insurance claims.
- Gaps in Public Health Schemes: Flagship schemes like Ayushman Bharat primarily focus on secondary and tertiary care. Preventive geriatric assessment, functional screening, and early interventions for ageing-related vulnerabilities receive limited attention, and frailty is not recognised as a reimbursable condition.
- Limited Reach of Geriatric Programmes: Although initiatives like the National Programme for Health Care of the Elderly exist, their implementation remains inadequate.
- Geriatric clinics are scarce at the district level, and healthcare workers rarely use standard frailty assessment tools.
- Inadequate Medical Training and Awareness: Medical education in India often treats ageing-related decline as inevitable, leading to underdiagnosis and neglect of frailty as a manageable condition.
- Multifactorial Nature of the Condition: Frailty arises from a combination of factors such as inflammation, muscle loss, immune dysfunction, and vascular ageing, making diagnosis and management complex.
Way Forward
- Integrating Frailty into Public Health Policy: Frailty should be recognised as a distinct clinical condition within the healthcare system. It must be incorporated into routine screening programmes and included under insurance coverage to ensure early diagnosis and financial protection for the elderly.
- Strengthening Geriatric Care: There is a need to expand geriatric care infrastructure by establishing dedicated clinics at the district level.
- Additionally, healthcare workers should be trained in the use of standardised frailty assessment tools to enable timely identification and management.
- Promoting Ethical Research: Greater emphasis should be placed on promoting evidence-based and ethical research, particularly through institutions like the Indian Council of Medical Research.
- Clinical trials on stem-cell therapies must ensure safety, affordability, and accessibility before large-scale adoption.
- Shifting to Preventive Ageing Care: Healthcare policy should move from a curative to a preventive approach by focusing on early detection, lifestyle interventions, and community-based care.
- This will help reduce hospitalisation rates and the overall burden on the healthcare system.
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Government of India Initiatives to Tackle Old Age Issues
- Ayushman Bharat: Provides health insurance coverage up to ₹5 lakh per family for secondary and tertiary care, benefiting elderly persons who require hospitalisation and reducing out-of-pocket expenditure.
- National Programme for Health Care of the Elderly (NPHCE): Focuses on accessible, affordable, and dedicated healthcare services for senior citizens through geriatric clinics, rehabilitation units, and community-based care.
- Atal Pension Yojana (APY): Ensures financial security in old age by providing a guaranteed pension to workers in the unorganised sector.
- Maintenance and Welfare of Parents and Senior Citizens Act, 2007: Legally mandates children and heirs to provide maintenance to senior citizens and ensures protection of their life and property.
- Rashtriya Vayoshri Yojana:Provides assistive living devices (such as walking sticks, hearing aids, wheelchairs) to senior citizens belonging to economically weaker sections
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Global Best Practices to Tackle Frailty
| Country / Organization |
Approach |
Key Measures |
| Japan |
Community-based preventive model |
Routine screening, focus on nutrition, exercise, and social participation |
| United Kingdom |
Primary healthcare integration |
Multidisciplinary care, early diagnosis |
| European Union |
Policy-level integration |
ADVANTAGE Joint Action on Frailty, focus on prevention and disability reduction |
| United States |
Clinical & research-driven model |
Use of frailty indices in hospitals, investment in trials (e.g., stem cell therapy) |
| World Health Organization (WHO) |
Global healthy ageing framework |
Integrated Care for Older People (ICOPE), focus on intrinsic capacity |
| South Korea |
Tech-enabled ageing care |
Digital health monitoring, preventive screening |
| Singapore |
Integrated community care |
Active ageing programmes, community health centres |
15 Apr 2026
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