Young adults who survived childhood cancer are more likely to be frail and at increased risk of death and chronic disease, U.S. researchers say. Kirsten Ness, an associate member of the St. Jude Department of Epidemiology and Cancer Control, and colleagues said being frail was defined by the presence of at least three of the following: weakness, self-reported exhaustion, physical inactivity, low muscle mass and slow walking speed. In the general population, it is most commonly associated with advancing age. Of the 1,922 childhood cancer survivors involved in the study, 13.1 percent of the women and 2.7 percent of the men qualified as frail despite having an average age 34 or younger. In a comparison group of 341 young adults with an average age of 29 and no history of childhood cancer, none qualified as frail. Nationally, an estimated 9.6 percent of women age 65 and older and 5.2 percent of men in the same age group meet the definition. The unexpectedly high prevalence of frailty among childhood cancer survivors suggests accelerated aging, researchers said. After adjusting for existing chronic health problems, researchers calculated that frail childhood cancer survivors were 2.6 times more likely to die than their non-frail counterparts. The study, published in the online edition of the Journal of Clinical Oncology, found the risk was highest for frail male survivors, who were at a six-fold increased risk of death compared with male survivors who were hearty. Frail child cancer survivors were also more than twice as likely as survivors who were hearty to develop additional chronic health problems. "There are steps survivors can take to reduce their risk and improve their fitness," Ness said in a statement. Exercise can reverse frailty in the elderly, Ness said, and this study reinforces the need for survivors to work with their healthcare providers to become more fit.