Cited by 428Frailty in Older AdultsNutrition and Health in AgingAging, Health, and Disability

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Prognostic Significance of Potential Frailty Criteria

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Rothman, Marc D., Leo‐Summers, Linda, Gill, Thomas M.·2008·Journal of the American Geriatrics Society

DOI 10.1111/j.1532-5415.2008.02008.xPMC PMC2782664

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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.

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“More recent studies are exploring the addition of cognition to the Fried’s components.(31) The findings from this trial clearly indicate a need for future work on telemonitoring and frailty.”
Efficacy of a home-based intervention programme on the physical activity level and functional ability of older people using domestic services: A randomised study
Bonnefoy, M., Boutitie, F., Mercier, C., Gueyffier, F., Carré, C., Guetemme, G., Ravis, B., Laville, M., & Cornu, C. (2011) · The journal of nutrition health & aging · doi:10.1007/s12603-011-0352-6 · Cited by 53
The impact of muscle function, muscle mass and sarcopenia on independent ageing in very old Swedish men
Franzon, K., Zethelius, B., Cederholm, T., & Kilander, L. (2019) · BMC Geriatrics · doi:10.1186/s12877-019-1142-y · Cited by 49
“In an American study, low GS and HGS were associated with institutionalisation six years later, independently of chronic conditions [43].”
BackgroundResult
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
Identifying frailty in high functioning older adults with normal mobility
Verghese, J., & Xue, X. (2010) · Age and Ageing · doi:10.1093/ageing/afp226 · Cited by 46
Gait Speed and Processing Speed as Clinical Markers for Geriatric Health Outcomes
Sanders, J. B., Bremmer, M. A., Comijs, H. C., van de Ven, P. M., Deeg, D. J. H., & Beekman, A. T. F. (2016) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2016.12.003 · Cited by 45
Frailty Level Classification of the Community Elderly Using Microsoft Kinect-Based Skeleton Pose: A Machine Learning Approach
Akbari, G., Nikkhoo, M., Wang, L., Chen, C. P. C., Han, D., Lin, Y., Chen, H.-B., & Cheng, C.-H. (2021) · Sensors · doi:10.3390/s21124017 · Cited by 46
“Frailty can be identified based on evaluation of the impairment in daily physical activities [9] and numerous studies utilized different techniques and approaches for this purpose.”
Method
Frailty: the missing piece of the pre- hematopoietic cell transplantation assessment?
Hegde, A. M., & Murthy, H. S. (2017) · Bone Marrow Transplantation · doi:10.1038/bmt.2017.192 · Cited by 44
Spatial and Temporal Parameters of Self-Selected and Fast Walking Speeds in Healthy Community-Living Adults Aged 72–98 Years
Chui, K. K., & Lusardi, M. M. (2010) · Journal of Geriatric Physical Therapy · doi:10.1519/jpt.0b013e3181ff262c · Cited by 44
Development and validation of the FRAGIRE tool for assessment an older person’s risk for frailty
Vernerey, D., Anota, A., Vandel, P., Paget‐Bailly, S., Dion, M., Bailly, V., Bonin, M., Pozet, A., Foubert, A., Benetkiewicz, M., et al. (2016) · BMC Geriatrics · doi:10.1186/s12877-016-0360-9 · Cited by 43
“Fried’s phenotype model could provide important information but fails to provide a complete assessment and to predict the occurrence of frailty in the general elderly population who are not yet frail [6, 12].”
Background
Frailty, cognitive impairment, and functional disability in older women with female pelvic floor dysfunction
Erekson, E. A., Fried, T. R., Martin, D. K., Rutherford, T. J., Strohbehn, K., & Bynum, J. P. W. (2015) · International Urogynecology Journal · doi:10.1007/s00192-014-2596-2 · Cited by 44
Frailty and Primary Sarcopenia: A Review
Carmeli, E. (2017) · Advances in experimental medicine and biology · doi:10.1007/5584_2017_18 · Cited by 42
The Risk Instrument for Screening in the Community (RISC): a new instrument for predicting risk of adverse outcomes in community dwelling older adults
Ó’Caoimh, R., Gao, Y., Svendrovski, A., Healy, E., O’Connell, E., O’Keeffe, G., Cronin, U. M., Igras, E., O’Herlihy, E. A., Fitzgerald, C., et al. (2015) · BMC Geriatrics · doi:10.1186/s12877-015-0095-z · Cited by 41
“This rise is associated with an increased prevalence of functional decline and frailty, in community dwelling older adults [2], creating risk of adverse healthcare outcomes [3].”
The prediction of disability by self-reported physical frailty components of the Tilburg Frailty Indicator (TFI)
Gobbens, R. J. J., van Assen, M. A. L. M., & Schalk, R. (2014) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2014.06.008 · Cited by 41
Using an accumulation of deficits approach to measure frailty in a population of home care users with intellectual and developmental disabilities: an analytical descriptive study
McKenzie, K., Ouellette-Kuntz, H. M. J., & Martin, L. (2015) · BMC Geriatrics · doi:10.1186/s12877-015-0170-5 · Cited by 42
“Others have noted that the strong influence of low mobility on frailty phenotype scores may lead to misclassification in the general population [21]; this may also lead to misclassification among those with IDD [10], who have higher rates of mobility limitations across the lifespan.”
Background
Specific Aspects of Breast Cancer Therapy of Elderly Women
Tesarova, P. (2016) · BioMed Research International · doi:10.1155/2016/1381695 · Cited by 41
Assessment of physical functioning in the clinical care of the patient with advanced kidney disease
Roshanravan, B., & Patel, K. V. (2019) · Seminars in Dialysis · doi:10.1111/sdi.12813 · Cited by 42
Oxidative Stress, Frailty and Cardiovascular Diseases: Current Evidence
Uchmanowicz, I. (2020) · Advances in experimental medicine and biology · doi:10.1007/978-3-030-33330-0_8 · Cited by 43
Prevalence and prognostic impact of physical frailty in interstitial lung disease: A prospective cohort study
Farooqi, M. A., O’Hoski, S., Goodwin, S., Makhdami, N., Aziz, A., Cox, G., Wald, J., Ryerson, C. J., Beauchamp, M., Hambly, N., et al. (2021) · Respirology · doi:10.1111/resp.14066 · Cited by 44
“It is an increasingly recognized prognostic marker in older adults and in those with chronic diseases.(4,5) Patients with ILD are often exposed to physiological stressors such as infectious or non-infectious respiratory exacerbations, which often result in poor outcomes.”
Background
The use of a frailty index to predict adverse health outcomes (falls, fractures, hospitalization, medication use, comorbid conditions) in people with intellectual disabilities
Schoufour, J. D., Echteld, M. A., Bastiaanse, L. P., & Evenhuis, H. M. (2015) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2014.12.001 · Cited by 39
Ageing with HIV
McGettrick, P., Barco, E. Á., & Mallon, P. W. G. (2018) · Healthcare · doi:10.3390/healthcare6010017 · Cited by 41
Reduced lateral occipital gray matter volume is associated with physical frailty and cognitive impairment in Parkinson’s disease
Chen, Y., Chen, H.-L., Lu, C., Chen, M., Chou, K., Tsai, N., Yu, C.-C., Chiang, P., & Lin, W. (2018) · European Radiology · doi:10.1007/s00330-018-5855-7 · Cited by 38
The operationalization of fatigue in frailty scales: a systematic review
Knoop, V., Costenoble, A., Azzopardi, R. V., Vermeiren, S., Debain, A., Jansen, B., Scafoglieri, A., Bautmans, I., Bautmans, I., Verté, D., et al. (2019) · Ageing Research Reviews · doi:10.1016/j.arr.2019.100911 · Cited by 40
Geriatric Conditions and the Risk of Adverse Drug Reactions in Older Adults
Lattanzio, F., Landi, F., Bustacchini, S., Abbatecola, A. M., Corica, F., Pranno, L., & Corsonello, A. (2012) · Drug Safety · doi:10.1007/bf03319103 · Cited by 39
Adaptação transcultural do instrumento Tilburg Frailty Indicator (TFI) para a população brasileira
Santiago, L. M., Luz, L. L., Mattos, I. E., & Gobbens, R. J. J. (2012) · Cadernos de Saúde Pública · doi:10.1590/s0102-311x2012000900018 · Cited by 38
Frailty, Dependency and Mortality Predictors in a Cohort of Cuban Older Adults, 2003–2011
Llibre, J. D. J., López, A. M., Valhuerdi, A., Guerra, M., Llibre‐Guerra, J. J., Sanchez, Y., Bosch, R., Llerena, T. Z., & Moreno, C. (2014) · MEDICC Review · doi:10.37757/mr2014.v16.n1.6 · Cited by 37
“The authors therefore stressed the limited value of the latter criteria.[38]”
Background
A comparison of the relationship of 14 performance-based measures with frailty in older women
Theou, O., Jones, G. R., Jakobi, J. M., Mitnitski, A., & Vandervoort, A. A. (2011) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/h11-116 · Cited by 38
Is Walking Speed a Vital Sign? Absolutely!
Lusardi, M. M. (2012) · Topics in Geriatric Rehabilitation · doi:10.1097/tgr.0b013e31824385a4 · Cited by 38
Physical Performance and Fall Risk in Persons With Traumatic Brain Injury
Klima, D. W., Morgan, L., Baylor, M., Reilly, C., Gladmon, D., & Davey, A. (2018) · Perceptual and Motor Skills · doi:10.1177/0031512518809203 · Cited by 36
Validating a widely used measure of frailty: are all sub-components necessary? Evidence from the Whitehall II cohort study
Bouillon, K., Sabia, S., Jokela, M. M., Galé, C. R., Singh‐Manoux, A., Shipley, M. J., Mika Kivimaki, B., & Batty, G. D. (2012) · AGE · doi:10.1007/s11357-012-9446-2 · Cited by 36
“Our results are consistent with those from a previous study (Rothman et al. 2008) where the authors found that slow walking speed was the strongest, and low grip strength the weakest, predictors of hospitalization.”
Result
Racial Differences in Gait Velocity in an Urban Elderly Cohort
Blanco, I., Verghese, J., Lipton, R. B., Putterman, C., & Derby, C. A. (2012) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2012.03927.x · Cited by 38
Association of frailty with the serine protease HtrA1 in older adults
Lorenzi, M., Lorenzi, T., Marzetti, E., Landi, F., Vetrano, D. L., Settanni, S., Antocicco, M., Bonassi, S., Valdiglesias, V., Bernabei, R., et al. (2016) · Experimental Gerontology · doi:10.1016/j.exger.2016.03.019 · Cited by 36
Surgery of the Elderly Patient
Karakoç, D. (2016) · International Surgery · doi:10.9738/intsurg-d-15-00261.1 · Cited by 35
Frailty, walking ability and self-rated health in predicting institutionalization: an 18-year follow-up study among Finnish community-dwelling older people
Viljanen, A. M., Salminen, M. J., Irjala, K. M. A., Korhonen, P. E., Wuorela, M., Isoaho, R. E., Kivelä, S., Vahlberg, T. J., Viitanen, M. H., Löppönen, M. K., et al. (2020) · Aging Clinical and Experimental Research · doi:10.1007/s40520-020-01551-x · Cited by 34
Frailty and intellectual disability: A different operationalization?
Evenhuis, H. M., Schoufour, J. D., & Echteld, M. A. (2013) · Developmental Disabilities Research Reviews · doi:10.1002/ddrr.1124 · Cited by 33
The Brave New World of Function-Promoting Anabolic Therapies: Testosterone and Frailty
Bhasin, S. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2550 · Cited by 33
Association Between Circulating Osteogenic Progenitor Cells and Disability and Frailty in Older Persons: The Nepean Osteoporosis and Frailty Study
Gunawardene, P., Bermeo, S., Vidal, C., Saedi, A. A., Chung, P., Boersma, D., Phu, S., Pokorski, I., Suriyaarachchi, P., Demontiero, O., et al. (2015) · The Journals of Gerontology Series A · doi:10.1093/gerona/glv190 · Cited by 32
Effectiveness of a Hybrid Exercise Program on the Physical Abilities of Frail Elderly and Explainable Artificial-Intelligence-Based Clinical Assistance
Meng, D., Guo, H., Liang, S., Tian, Z., Wang, R., Yang, G., & Wang, Z. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19126988 · Cited by 32
“The ten-meter maximum walking speed was determined since it was significantly associated with changes in frailty [39] and has good validity in the elderly [40].”
Background
The frailty syndrome
Conroy, S., & Elliott, A. (2016) · Medicine · doi:10.1016/j.mpmed.2016.10.010 · Cited by 31
Respiratory Impairment in Older Persons: When Less Means More
Fragoso, C. A. V., Gill, T. M., McAvay, G., Quanjer, P. H., Ness, P. H. V., & Concato, J. (2012) · The American Journal of Medicine · doi:10.1016/j.amjmed.2012.07.016 · Cited by 32
“Gait speed, an objective measure of mobility, is strongly associated with disability, hospitalization, and mortality.(7,11) Mobility disability, as dened in the present study, is associated with higher rates of orbidity, self-care disability, social isolation, healthcare se, and mortality.”
BackgroundSelf-citation
Do exercise habits during middle age affect locomotive syndrome in old age?
Nishimura, A., Ito, N., Asanuma, K., Akeda, K., Ogura, T., & Sudo, A. (2017) · Modern Rheumatology · doi:10.1080/14397595.2017.1333670 · Cited by 31
“[17] performed a cohort study of community-living persons aged 70 years and older and showed that low physical activity was associated with chronic disability, long-term nursing home stays, and death.”
Background
Frailty Assessment in the Emergency Department
Stiffler, K. A., Finley, A., Midha, S., & Wilber, S. T. (2013) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2012.11.047 · Cited by 30
Non-hematologic predictors of mortality improve the prognostic value of the international prognostic scoring system for MDS in older adults
Fega, K. R., Abel, G. A., Motyckova, G., Sherman, A. E., DeAngelo, D. J., Steensma, D. P., Galinsky, I. A., Wadleigh, M., Stone, R. M., & Driver, J. A. (2015) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2015.05.003 · Cited by 30

Authors: Rothman, M. D., Leo‐Summers, L., & Gill, T. M.
Affiliations: Yale University (US)
Corresponding author: Rothman, Marc D.
ORCID: Gill, Thomas M.
Venue: Journal of the American Geriatrics Society
Publisher: Wiley
Published: 2008-12
Volume: 56
Issue: 12
Pages: 2211-2216
ISSN: 0002-8614 (ISSN-L)
1532-5415
DOI: 10.1111/j.1532-5415.2008.02008.x
PMC: PMC2782664
OpenAlex: W2111326370
Cited by: 428
References: 49
Citations by year: 2026: 2 · 2025: 10 · 2024: 8 · 2023: 20 · 2022: 11 · 2021: 24 · 2020: 24 · 2019: 30 · 2018: 21 · 2017: 33 · 2016: 44 · 2015: 42 · 2014: 33 · 2013: 34 · 2012: 29
FWCI: 8.49
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of the American Geriatrics Society (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Aging (R01AG022993, R37AG017560, K24AG021507, T32 AG1934, T32AG019134, P30AG021342)
Topics: Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
Keywords: frailty, Fried criteria, slow walking, physical activity, weight loss, cognitive impairment, exhaustion, muscle weakness, chronic disability, falls, mortality, older adults, prognostic factors
MeSH terms: Aged, Female, Humans, Male, Prognosis, Prospective Studies, Geriatric Assessment, Frail Elderly

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Prognostic Significance of Potential Frailty Criteria

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