Frailty in relation to the accumulation of deficits
Abstract
This review article summarizes how frailty can be considered in relation to deficit accumulation. Recalling that frailty is an age-associated, nonspecific vulnerability, we consider symptoms, signs, diseases, and disabilities as deficits, which are combined in a frailty index. An individual's frailty index score reflects the proportion of potential deficits present in that person, and indicates the likelihood that frailty is present. Although based on a simple count, the frailty index shows several interesting properties, including a characteristic rate of accumulation, a submaximal limit, and characteristic changes with age in its distribution. The frailty index, as a state variable, is able to quantitatively summarize vulnerability. Future studies include the application of network analyses and stochastic analytical techniques to the evaluation of the frailty index and the description of other state variables in relation to frailty.
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A frailty index value of 0.67 appears to identify a level beyond which further deficit accumulation is not sustainable and death is likely.
“a value of 0.67 appears to identify a level of frailty beyond which further deficit accumulation is not sustainable and death is likely to supervene (78).”
From Frailty in elderly people (2013) · cites this paper as [78]
The results yielded by the frailty index have been consistent between surveys evaluated by our group and by others even though not every frailty index considers the same deficits or number of deficits.
“the results yielded by the frailty index have been consistent between surveys evaluated by our group [4-7] and by others [8-11] even though not every frailty index considers the same deficits, or even the same number of deficits.”
From A standard procedure for creating a frailty index (2008) · cites this paper as [5]
Across several frailty index measures, people accumulate deficits, on average, at about 0.03/year.
“across several frailty index measures, people accumulate deficits, on average, at about 0.03/year [4,5].”
From A standard procedure for creating a frailty index (2008) · cites this paper as [5]
In each study, the frailer the person is (the higher the deficit count) the more vulnerable they are to adverse outcomes.
“In each study, the frailer the person is (the higher the deficit count) the more vulnerable they are to adverse outcomes [5,8,11].”
From A standard procedure for creating a frailty index (2008) · cites this paper as [5]
The frailty index shows a consistent, sub-maximal limit at about 2/3 of the deficits that are considered.
“The frailty index also shows a consistent, sub-maximal limit at about 2/3 of the deficits that are considered.”
From A standard procedure for creating a frailty index (2008) · cites this paper as [5]
A frailty index can be constructed using information that is readily available in most health surveys, and is clinically tractable.
“a frailty index can be constructed using information that is readily available in most health surveys, and is clinically tractable – i.e. it uses an amount that would be gathered in many routine health assessments of older adults [5].”
From A standard procedure for creating a frailty index (2008) · cites this paper as [5]
It does not matter if study A considered 40 deficits from set X and study B considered 60 deficits from set Y; the estimates from each (e.g. rate of deficit accumulation, relationship with mortality, limit) appear to be similar.
“it does not matter if study A considered 40 deficits from set X of deficits and study B considered 60 deficits from set Y of deficits; the estimates from each (e.g. the rate of deficit accumulation, the relationship between deficit accumulation and mortality, or the limit to deficit accumulation) appear to be similar.”
From A standard procedure for creating a frailty index (2008) · cites this paper as [5]
Mortality exponentially increases with the accumulation of deficits.
“mortality exponentially increases with the accumulation of deficits [5,8,19].”
From A standard procedure for creating a frailty index (2008) · cites this paper as [5]
The frailty index is strongly associated with the risk of death, institutionalization and worsening health status, especially when at least 30 variables are included.
“The frailty index is strongly associated with the risk of death, institutionalization and worsening health status, especially when at least 30 variables are included [5].”
From A standard procedure for creating a frailty index (2008) · cites this paper as [5]
Deficits in a frailty index are defined as symptoms, signs, disabilities and diseases.
“These deficits were defined as symptoms, signs, disabilities and diseases [5].”
From A standard procedure for creating a frailty index (2008) · cites this paper as [5]
Cites
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282 · see citing works
Frailty in Older Adults: Evidence for a Phenotype
Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., Seeman, T., Tracy, R., Kop, W. J., Burke, G., et al. (2001) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/56.3.m146 · Cited by 24,907 · see citing works
A global clinical measure of fitness and frailty in elderly people
Rockwood, K. (2005) · Canadian Medical Association Journal · doi:10.1503/cmaj.050051 · Cited by 8,968 · see citing works
Self-citationAn introduction to cybernetics
Ashby, W. R. (1956) · doi:10.5962/bhl.title.5851 · Cited by 7,578 · see citing works
Fried, L. P., Ferrucci, L., Darer, J., Williamson, J. D., & Anderson, G. (2004) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/59.3.m255 · Cited by 4,032 · see citing works
Accumulation of Deficits as a Proxy Measure of Aging
Mitnitski, A. B., Mogilner, A. J., & Rockwood, K. (2001) · The Scientific World JOURNAL · doi:10.1100/tsw.2001.58 · Cited by 2,893 · cited 1× · see citing works
“Instead, the frailty index can be considered as a state variable, in that it characterizes the whole health of individuals and validly classifies risk across a wide range of people (7,46).”
BackgroundSelf-citationThe impact of heterogeneity in individual frailty on the dynamics of mortality
Vaupel, J. W., Mantón, K. G., & Stallard, E. (1979) · Demography · doi:10.2307/2061224 · Cited by 2,600 · see citing works
Understanding the odd science of aging
Kirkwood, T. B. L. (2005) · Cell · doi:10.1016/j.cell.2005.01.027 · Cited by 1,984 · see citing works
Phenotype of frailty: characterization in the women's health and aging studies
Bandeen-Roche, K., Xue, Q.-L., Ferrucci, L., Walston, J., Guralnik, J. M., Chaves, P., Zeger, S. L., & Fried, L. P. (2006) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/61.3.262 · Cited by 1,215 · see citing works
Fried, L. P. (2001) · Journals of Gerontology Series A-biological Sciences and Medical Sciences · Cited by 1,103 · see citing works
Ferrucci, L., Guralnik, J. M., Studenski, S., Fried, L. P., Cutler, G. B., Walston, J. D., & The Interventions on Frailty Working Group (2004) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2004.52174.x · Cited by 1,027 · cited 1× · see citing works
“More controversial is how to operationalize frailty in clinical practice and for research (1-6).”
BackgroundA brief clinical instrument to classify frailty in elderly people
Rockwood, K. J., Stadnyk, K., MacKnight, C., McDowell, I., Hébert, R., & Hogan, D. B. (1999) · The Lancet · doi:10.1016/s0140-6736(98)04402-x · Cited by 914 · see citing works
Self-citationDevelopment and Validation of a Prognostic Index for 4-Year Mortality in Older Adults
Lee, S. J. (2006) · JAMA · doi:10.1001/jama.295.7.801 · Cited by 809 · see citing works
Elements of the theory of Markov processes and their applications
(1960) · Journal of the Franklin Institute · doi:10.1016/0016-0032(60)90686-4 · Cited by 734 · see citing works
Frailty, fitness and late-life mortality in relation to chronological and biological age
Mitnitski, A. B., Graham, J., Mogilner, A. J., & Rockwood, K. J. (2002) · BMC Geriatrics · doi:10.1186/1471-2318-2-1 · Cited by 711 · see citing works
Self-citationThe Reliability Theory of Aging and Longevity
Gavrilov, L. A., & Gavrilova, N. S. (2001) · Journal of Theoretical Biology · doi:10.1006/jtbi.2001.2430 · Cited by 620 · see citing works
Operationalizing a frailty index from a standardized comprehensive geriatric assessment
Jones, D. M., Song, X., & Rockwood, K. (2004) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2004.52521.x · Cited by 605 · see citing works
Self-citationFrailty in elderly people: an evolving concept.
Rockwood, K. J., Fox, R. A., Stolee, P., Robertson, D., & Beattie, B. L. (1994) · PubMed Central · Cited by 598 · see citing works
Self-citationGeneral Theory of Mortality and Aging
Strehler, B. L., & Mildvan, A. S. (1960) · Science · doi:10.1126/science.132.3418.14 · Cited by 581 · see citing works
Mitnitski, A., Song, X., Skoog, I., Broe, G., Cox, J. L., Grunfeld, E., & Rockwood, K. (2005) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2005.00506.x · Cited by 547 · see citing works
Self-citationMitochondrial DNA mutations in human colonic crypt stem cells
Taylor, R. W., Barron, M. J., Borthwick, G. M., Gospel, A., Chinnery, P. F., Samuels, D. C., Taylor, G. A., Plusa, S. M., Needham, S. J., Greaves, L. C., et al. (2003) · Journal of Clinical Investigation · doi:10.1172/jci19435 · Cited by 530 · see citing works
Rockwood, K., Mitnitski, A., Song, X., Steen, B., & Skoog, I. (2006) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2006.00738.x · Cited by 481 · see citing works
Self-citationA Developmental Timing MicroRNA and Its Target Regulate Life Span in C. elegans
Boehm, M., & Slack, F. J. (2005) · Science · doi:10.1126/science.1115596 · Cited by 449 · see citing works
Models, Definitions, and Criteria of Frailty
Hogan, D. B. (2006) · Elsevier eBooks · doi:10.1016/b978-012369391-4/50051-5 · Cited by 410 · see citing works
What would make a definition of frailty successful?
Rockwood, K. J. (2005) · Age and Ageing · doi:10.1093/ageing/afi146 · Cited by 382 · see citing works
Self-citationSocial Determinants of Frailty
Woo, J., Goggins, W., Sham, A., & Ho, S. C. (2005) · Gerontology · doi:10.1159/000088705 · Cited by 301 · see citing works
Frailty and Its Definition: A Worthy Challenge
Rockwood, K. J. (2005) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2005.53312.x · Cited by 288 · see citing works
Self-citationJones, D., Song, X., Mitnitski, A., & Rockwood, K. (2005) · Aging Clinical and Experimental Research · doi:10.1007/bf03327413 · Cited by 267 · see citing works
Self-citationThe mortality rate as a function of accumulated deficits in a frailty index
Mitnitski, A. B., Mogilner, A. J., MacKnight, C., & Rockwood, K. J. (2002) · Mechanisms of Ageing and Development · doi:10.1016/s0047-6374(02)00082-9 · Cited by 264 · see citing works
Self-citationLimits to deficit accumulation in elderly people
Rockwood, K. J., & Mitnitski, A. (2006) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2006.01.002 · Cited by 237 · see citing works
Self-citationAging: The Reality: Biomarkers of Aging: From Primitive Organisms to Humans
Butler, R. N., Sprott, R., Warner, H. R., Bland, J. S., Feuers, R. J., Forster, M. J., Fillit, H. M., Harman, S. M., Hewitt, M., Hyman, M., et al. (2004) · The Journals of Gerontology Series A · doi:10.1093/gerona/59.6.b560 · Cited by 201 · see citing works
Rockwood, K. J., Stolee, P., & McDowell, I. (1996) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1996.tb01446.x · Cited by 195 · see citing works
Self-citationChanges with age in the distribution of a frailty index
Rockwood, K. J. (2004) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2004.05.003 · Cited by 155 · see citing works
Self-citationKirkwood, T. B. L., Feder, M., Finch, C. E., Franceschi, C., Globerson, A., Klingenberg, C. P., LaMarco, K., Omholt, S., & Westendorp, R. G. J. (2005) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2004.09.008 · Cited by 144 · see citing works
Karasik, D., Demissie, S., Cupples, L. A., & Kiel, D. P. (2005) · The Journals of Gerontology Series A · doi:10.1093/gerona/60.5.574 · Cited by 141 · see citing works
Separating Internal and External Dynamics of Complex Systems
de Menezes, M. A., & Barabási, A.-Ĺ. (2004) · Physical Review Letters · doi:10.1103/physrevlett.93.068701 · Cited by 137 · see citing works
Kulminski, A., Yashin, A., Arbeev, K., Akushevich, I., Ukraintseva, S., Land, K., & Manton, K. (2007) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2006.12.004 · Cited by 132 · see citing works
Accumulation of health disorders as a systemic measure of aging: Findings from the NLTCS data
Kulminski, A. M., Yashin, A. I., Ukraintseva, S. V., Akushevich, I. V., Arbeev, K. G., Land, K. C., & Mantón, K. G. (2006) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2006.08.005 · Cited by 124 · see citing works
Public health significance of the frailty index
Woo, J., Goggins, W. B., Sham, A., & Ho, S. C. (2005) · Disability and Rehabilitation · doi:10.1080/09638280500215867 · Cited by 110 · see citing works
Mitnitski, A., Bao, L., & Rockwood, K. J. (2006) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2006.01.007 · Cited by 106 · see citing works
Self-citationAge-related mitochondrial DNA deletion in human heart: Its relationship with cardiovascular diseases
Arai, T., Nakahara, K., Matsuoka, H., Sawabe, M., Chida, K., Matsushita, S., Takubo, K., Honma, N., Nakamura, K., Izumiyama, N., et al. (2003) · Aging Clinical and Experimental Research · doi:10.1007/bf03324472 · Cited by 99 · see citing works
Fisher, A. L. (2005) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2005.00510.x · Cited by 87 · see citing works
Yashin, A. I., Ukraintseva, S. V., BENEDICTIS, G. D., Anisimov, V. N., Бутов, А. А., Arbeev, K. G., Jdanov, D. A., Boiko, S. I., Begun, A., Bonafè, M., et al. (2001) · The Journals of Gerontology Series A · doi:10.1093/gerona/56.10.b432 · Cited by 83 · see citing works
Song, X., Mitnitski, A., MacKnight, C., & Rockwood, K. J. (2004) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2004.52319.x · Cited by 79 · see citing works
Self-citationMitochondrial DNA mutations in human colonic crypt stem cells
Taylor, R. W., Barron, M. J., Borthwick, G. M., et al. (2003) · Journal of Clinical Investigation · doi:10.1172/jci200319435 · Cited by 72 · see citing works
Rasch analysis of the hierarchical assessment of balance and mobility (HABAM)
MacKnight, C., & Rockwood, K. J. (2000) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(00)00255-9 · Cited by 65 · see citing works
Self-citationWarner, H. R. (2004) · The Journals of Gerontology Series A · doi:10.1093/gerona/59.7.b692 · Cited by 60 · see citing works
Comprehensive geriatric assessment
Rockwood, K. J., Silvius, J. L., & Fox, R. A. (1998) · Postgraduate Medicine · doi:10.3810/pgm.1998.03.424 · Cited by 58 · see citing works
Self-citationParentini, I., Cavallini, G., Donati, A., Gori, Z., & Bergamini, E. (2005) · The Journals of Gerontology Series A · doi:10.1093/gerona/60.1.39 · Cited by 48 · see citing works
Thaler, D. S. (2002) · Neurobiology of Aging · doi:10.1016/s0197-4580(01)00262-7 · Cited by 25 · see citing works
Decrease in the relative heterogeneity of health with age: A cross-national comparison
Mitnitski, A., & Rockwood, K. J. (2005) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2005.09.007 · Cited by 21 · see citing works
Self-citationAge-Associated Disorders As A Proxy Measure Of Biological Age: Findings From the NLTCS DataPreprint
Kulminski, A. M., Yashin, A. I., Ukraintseva, S. V., et al. (2005) · arXiv (Cornell University) · doi:10.48550/arxiv.q-bio/0509034 · Cited by 2 · see citing works
Help Available--Phenomenological Models for Research on Aging
Mitnitski, A., & Rockwood, K. J. (2003) · Science of Aging Knowledge Environment · doi:10.1126/sageke.2003.12.vp2 · Cited by 2 · see citing works
Self-citationKulminski, A. M., Yashin, A. I., Akushevich, I. V., Ukraintseva, S. V., Land, K., Arbeev, K. G., & Manton, K. (2005) · arXiv (Cornell University) · doi:10.48550/arxiv.q-bio/0509038 · Cited by 1 · see citing works
A Note on Age-Related Biomarkers
Weale, R. A. (2005) · The Journals of Gerontology Series A · doi:10.1093/gerona/60.1.35 · Cited by 1 · see citing works
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Clegg, A., Young, J., Iliffe, S., Rikkert, M. O., & Rockwood, K. (2013) · The Lancet · doi:10.1016/s0140-6736(12)62167-9 · Cited by 9,503 · see citing works
Self-citationA standard procedure for creating a frailty index
Searle, S. D., Mitnitski, A., Gahbauer, E. A., Gill, T. M., & Rockwood, K. (2008) · BMC Geriatrics · doi:10.1186/1471-2318-8-24 · Cited by 3,568 · see citing works
Self-citationA comparison of two approaches to measuring frailty in elderly people
Rockwood, K., Andrew, M., & Mitnitski, A. (2007) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/62.7.738 · Cited by 1,291 · see citing works
Self-citationFragala, M. S., Cadore, E. L., Dorgo, S., Izquierdo, M., Kraemer, W. J., Peterson, M. D., & Ryan, E. D. (2019) · Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000003230 · Cited by 1,290 · see citing works
Prevalence and 10‐Year Outcomes of Frailty in Older Adults in Relation to Deficit Accumulation
Song, X., Mitnitski, A., & Rockwood, K. (2010) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2010.02764.x · Cited by 1,104 · see citing works
Self-citationCadore, E. L., Rodríguez-Mañas, L., Sinclair, A., & Izquierdo, M. (2013) · Rejuvenation Research · doi:10.1089/rej.2012.1397 · Cited by 954 · see citing works
Liu, Z., Kuo, P.-L., Horvath, S., Crimmins, E., Ferrucci, L., & Levine, M. (2018) · PLOS Medicine · doi:10.1371/journal.pmed.1002718 · Cited by 754 · see citing works
The effectiveness of exercise interventions for the management of frailty: a systematic review
Theou, O., Stathokostas, L., Roland, K. P., Jakobi, J. M., Patterson, C., Vandervoort, A. A., & Jones, G. R. (2011) · Journal of Aging Research · doi:10.4061/2011/569194 · Cited by 652 · see citing works
Type 2 diabetes mellitus in older adults: clinical considerations and management
Bellary, S., Kyrou, I., Brown, J. E., & Bailey, C. J. (2021) · Nature Reviews Endocrinology · doi:10.1038/s41574-021-00512-2 · Cited by 639 · see citing works
Gale, C. R., Westbury, L., & Cooper, C. (2018) · Age and Ageing · doi:10.1093/ageing/afx188 · Cited by 590 · see citing works
“A frailty index score reflects the proportion of potential deficits present [12].”
BackgroundHeterogeneous aging across multiple organ systems and prediction of chronic disease and mortality
Tian, Y. E., Cropley, V., Maier, A. B., Lautenschlager, N. T., Breakspear, M., & Zalesky, A. (2023) · Nature Medicine · doi:10.1038/s41591-023-02296-6 · Cited by 618 · see citing works
Cadore, E. L., Casas-Herrero, A., Zambom-Ferraresi, F., Idoate, F., Millor, N., Gómez, M., Rodriguez-Mañas, L., & Izquierdo, M. (2014) · AGE · doi:10.1007/s11357-013-9586-z · Cited by 526 · see citing works
Microbial shifts in the aging mouse gut
Langille, M. G., Meehan, C. J., Koenig, J. E., Dhanani, A. S., Rose, R. A., Howlett, S. E., & Beiko, R. G. (2014) · Microbiome · doi:10.1186/s40168-014-0050-9 · Cited by 437 · see citing works
Collerton, J., Martin-Ruiz, C., Davies, K., Hilkens, C. M., Isaacs, J., Kolenda, C., Parker, C., Dunn, M., Catt, M., Jagger, C., et al. (2012) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2012.05.005 · Cited by 420 · see citing works
The exerkine apelin reverses age-associated sarcopenia
Vinel, C., Lukjanenko, L., Batut, A., Deleruyelle, S., Pradère, J.-P., Le Gonidec, S., Dortignac, A., Geoffre, N., Pereira, O., Karaz, S., et al. (2018) · Nature Medicine · doi:10.1038/s41591-018-0131-6 · Cited by 398 · see citing works
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Benefits of resistance training in physically frail elderly: a systematic review
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Dedeyne, L., Deschodt, M., Verschueren, S., Tournoy, J., & Gielen, E. (2017) · Clinical Interventions in Aging · doi:10.2147/cia.s130794 · Cited by 315 · see citing works
Frailty for Surgeons: Review of a National Institute on Aging Conference on Frailty for Specialists
Robinson, T. N., Walston, J. D., Brummel, N. E., Deiner, S., Brown, C. H., Kennedy, M., & Hurria, A. (2015) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2015.08.428 · Cited by 304 · see citing works
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Oxidative stress and frailty: A systematic review and synthesis of the best evidence
Soysal, P., Isik, A. T., Carvalho, A. F., Fernandes, B. S., Solmi, M., Schofield, P., Veronese, N., & Stubbs, B. (2017) · Maturitas · doi:10.1016/j.maturitas.2017.01.006 · Cited by 252 · see citing works
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Rockwood, K., Abeysundera, M. J., & Mitnitski, A. (2007) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2007.07.012 · Cited by 249 · see citing works
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The relationship between depression and frailty syndrome: a systematic review
Buigues, C., Padilla-Sánchez, C., Garrido, J. F., Navarro-Martínez, R., Ruiz-Ros, V., & Cauli, O. (2015) · Aging & Mental Health · doi:10.1080/13607863.2014.967174 · Cited by 235 · see citing works
Nontraditional risk factors combine to predict Alzheimer disease and dementia
Song, X., Mitnitski, A., & Rockwood, K. (2011) · Neurology · doi:10.1212/wnl.0b013e318225c6bc · Cited by 220 · see citing works
Self-citationAge-related deficit accumulation and the diseases of ageing
Rockwood, K., & Howlett, S. E. (2019) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2019.04.005 · Cited by 198 · see citing works
Self-citationFrailty in childhood cancer survivors
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Schwenk, M., Mohler, J., Wendel, C., D''Huyvetter, K., Fain, M., Taylor-Piliae, R., & Najafi, B. (2015) · Gerontology · doi:10.1159/000369095 · Cited by 184 · see citing works
Exercise Intolerance in Older Adults With Heart Failure With Preserved Ejection Fraction
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Metzelthin, S. F., Daniëls, R., van Rossum, E., de Witte, L., van den Heuvel, W. J., & Kempen, G. I. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-176 · Cited by 169 · see citing works
Cadore, E. L., Moneo, A. B. B., Mensat, M. M., Muñoz, A. R., Casas-Herrero, A., Rodriguez-Mañas, L., & Izquierdo, M. (2014) · AGE · doi:10.1007/s11357-013-9599-7 · Cited by 151 · see citing works
Cadore, E. L., Sáez de Asteasu, M. L., & Izquierdo, M. (2019) · Experimental Gerontology · doi:10.1016/j.exger.2019.04.007 · Cited by 112 · see citing works
Casas-Herrero, A., Cadore, E. L., Zambom-Ferraresi, F., Idoate, F., Millor, N., Martínez-Ramirez, A., Gómez, M., Rodriguez-Mañas, L., Marcellán, T., de Gordoa, A. R., et al. (2013) · Rejuvenation Research · doi:10.1089/rej.2013.1438 · Cited by 105 · see citing works
Izquierdo, M., & Cadore, E. L. (2014) · Current Medical Research and Opinion · doi:10.1185/03007995.2014.908175 · Cited by 97 · see citing works
Adherence to Mediterranean Diet and Frailty
Ntanasi, E., Yannakoulia, M., Kosmidis, M.-H., Anastasiou, C. A., Dardiotis, E., Hadjigeorgiou, G., Sakka, P., & Scarmeas, N. (2018) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2017.11.005 · Cited by 94 · see citing works
Aging, immune senescence, and immunotherapy: a comprehensive review
Elias, R., Hartshorn, K., Rahma, O., Lin, N., & Snyder-Cappione, J. E. (2018) · Seminars in Oncology · doi:10.1053/j.seminoncol.2018.08.006 · Cited by 96 · see citing works
Role of sarcopenia in the frailty transitions in older adults: a population-based cohort study
Álvarez‐Bustos, A., Carnicero‐Carreño, J. A., Davies, B., Garcia‐Garcia, F. J., Rodríguez‐Artalejo, F., Rodríguez‐Mañas, L., & Alonso‐Bouzón, C. (2022) · Journal of Cachexia, Sarcopenia and Muscle · doi:10.1002/jcsm.13055 · Cited by 79 · see citing works
Atrial remodeling and atrial fibrillation in acquired forms of cardiovascular disease
Jansen, H. J., Bohne, L. J., Gillis, A. M., & Rose, R. A. (2020) · Heart Rhythm O2 · doi:10.1016/j.hroo.2020.05.002 · Cited by 74 · see citing works
Factors associated with geriatric syndromes in older homeless adults
Brown, R. T., Kiely, D. K., Bharel, M., & Mitchell, S. L. (2013) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2013.0077 · Cited by 71 · see citing works
Makai, P., Perry, M., Robben, S. H., Schers, H. J., Heinen, M. M., Olde Rikkert, M. G., & Melis, R. F. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3057 · Cited by 59 · see citing works
Tajar, A., O'Connell, M. D. L., Mitnitski, A. B., O'Neill, T. W., Searle, S. D., Huhtaniemi, I. T., Finn, J. D., Bartfai, G., Boonen, S., Casanueva, F. F., et al. (2011) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2011.03398.x · Cited by 63 · see citing works
Self-citationDepression and incidence of frailty in older people from six Latin American countries
Prina, A. M., Stubbs, B., Veronese, N., Guerra, M., Kralj, C., Llibre Rodriguez, J. J., Prince, M., & Wu, Y.-T. (2019) · The American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2019.04.008 · Cited by 59 · see citing works
Sex-specific health deterioration and mortality: the morbidity–mortality paradox over age and time
Kulminski, A. M., Culminskaya, I. V., Ukraintseva, S. V., Arbeev, K. G., Land, K. C., & Yashin, A. I. (2008) · Experimental Gerontology · doi:10.1016/j.exger.2008.09.007 · Cited by 56 · see citing works
Depressive symptoms and frailty
St. John, P. D., Tyas, S. L., & Montgomery, P. R. (2013) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.3866 · Cited by 51 · see citing works
Frailty: A Vital Sign for Older Adults With Cardiovascular Disease
Forman, D. E., & Alexander, K. P. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.05.015 · Cited by 47 · see citing works
Comprehensive Peri-Operative Risk Assessment and Management of Geriatric Patients
Theodorakis, N., Nikolaou, M., Hitas, C., Anagnostou, D., Kreouzi, M., Kalantzi, S., Spyridaki, A., Triantafylli, G., Metheniti, P., & Papaconstantinou, I. (2024) · Diagnostics · doi:10.3390/diagnostics14192153 · Cited by 41 · see citing works
Fragility Fracture Nursing: Holistic Care and Management of the Orthogeriatric Patient
(2018) · Perspectives in Nursing Management and Care for Older Adults · doi:10.1007/978-3-319-76681-2 · Cited by 40 · see citing works
Espinoza, S. E., Woods, R. L., Ekram, A. R. M. S., Ernst, M. E., Polekhina, G., Wolfe, R., Shah, R. C., Ward, S. A., Storey, E., Nelson, M. R., et al. (2022) · The Journals of Gerontology: Series A · doi:10.1093/gerona/glab340 · Cited by 39 · see citing works
Ortolá, R., García-Esquinas, E., Soler-Vila, H., Ordovas, J. M., López-García, E., & Rodríguez-Artalejo, F. (2019) · Journal of Epidemiology and Community Health · doi:10.1136/jech-2018-211104 · Cited by 12 · see citing works
Noppert, G. A., Aiello, A. E., O'Rand, A. M., & Cohen, H. J. (2018) · Epidemiology and Infection · doi:10.1017/s095026881800153x · Cited by 11 · see citing works
Older men’s definitions of frailty – the Manitoba follow-up study
St. John, P. D., McClement, S. S., Swift, A. U., & Tate, R. B. (2019) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980818000405 · Cited by 10 · see citing works
Dominguez, L. J., & Barbagallo, M. (2013) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2012.09.029 · Cited by 9 · see citing works
Moody, E., McDougall, H., Paus Jenssen, E., McArthur, C., Affoo, R., Weeks, L. E., Macdonald, M., Mojbafan, A., & Langman, E. (2026) · BMC Geriatrics · doi:10.1186/s12877-026-07011-x · Cited by 1 · see citing works
- Authors
- Rockwood, K., & Mitnitski, A.
- Affiliations
- Dalhousie University (CA)
- Corresponding author
- Rockwood, K.
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-07-01
- Volume
- 62
- Issue
- 7
- Pages
- 722-727
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- OpenAlex
- W2129700906
- Cited by
- 3,076
- References
- 55
- Citations by year
- 2026: 368 · 2025: 304 · 2024: 309 · 2023: 251 · 2022: 278 · 2021: 255 · 2020: 241 · 2019: 195 · 2018: 171 · 2017: 159 · 2016: 128 · 2015: 84 · 2014: 70 · 2013: 65 · 2012: 55
- FWCI
- 2.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- frailty, frailty index, deficit accumulation, age-related susceptibility, state variables, aging, network analysis, stochastic modeling
- MeSH terms
- Aged, Aged, 80 and over, Aging, Humans, Mathematics, Models, Theoretical, Frail Elderly
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