Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Dec;56(12):2211-16.
doi: 10.1111/j.1532-5415.2008.02008.x.

Prognostic significance of potential frailty criteria

Marc D Rothman  1 , Linda Leo-Summers, Thomas M Gill
Affiliations

Prognostic significance of potential frailty criteria

Marc D Rothman et al. J Am Geriatr Soc. 2008 Dec.

Abstract

Objectives: To determine the independent prognostic effect of seven potential frailty criteria, including five from the Fried phenotype, on several adverse outcomes.

Design: Prospective cohort study.

Setting: Greater New Haven, Connecticut.

Participants: Seven hundred fifty-four initially nondisabled, community-living persons aged 70 and older.

Measurements: An assessment of seven potential frailty criteria (slow gait speed, low physical activity, weight loss, exhaustion, weakness, cognitive impairment, and depressive symptoms) was completed at baseline and every 18 months for 72 months. Participants were followed with monthly telephone interviews for up to 96 months to determine the occurrence of chronic disability, long-term nursing home (NH) stays, injurious falls, and death.

Results: In analyses adjusted for age, sex, race, education, number of chronic conditions, and the presence of the other potential frailty criteria, three of the five Fried criteria (slow gait speed, low physical activity, and weight loss) were independently associated with chronic disability, long-term NH stays, and death. Slow gait speed was the strongest predictor of chronic disability (hazard ratio (HR)=2.97, 95% confidence interval (CI)=2.32-3.80) and long-term NH stay (HR=3.86, 95% CI=2.23-6.67) and was the only significant predictor of injurious falls (HR=2.19, 95% CI=1.33-3.60). Cognitive impairment was also associated with chronic disability (HR=1.82, 95% CI=1.40-2.38), long-term NH stay (HR=2.64, 95% CI=1.75-3.99), and death (HR=1.54, 95% CI=1.13-2.10), and the magnitude of these associations was comparable with that of weight loss.

Conclusion: The results of this study provide strong evidence to support the use of slow gait speed, low physical activity, weight loss, and cognitive impairment as key indicators of frailty while raising concerns about the value of self-reported exhaustion and muscle weakness.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Prevalence of Potential Frailty Criteria Over 72 Months
Figure 2
Figure 2
Kaplan-Meier Curves for Adverse Outcomes
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–M156. - PubMed
    1. Ensrud KE, Ewing SK, Taylor BC, et al. Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Arch Intern Med. 2008;168:382–389. - PubMed
    1. Puts MT, Lips P, Deeg DJ. Sex differences in the risk of frailty for mortality independent of disability and chronic diseases. J Am Geriatr Soc. 2005;53:40–47. - PubMed
    1. Studenski S, Hayes RP, Leibowitz RQ, et al. Clinical Global Impression of Change in Physical Frailty: development of a measure based on clinical judgment. J Am Geriatr Soc. 2004;52:1560–1566. - PubMed
    1. Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. Can Med Assoc J. 2005;173:489–495. - PMC - PubMed

Publication types