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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“Slow gait speeds are associated with falls, disability, institutionalization and death [27,28].”
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Background
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Background
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Method
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Background
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Background
Association of Serious Fall Injuries among United States End Stage Kidney Disease Patients with Access to Kidney Transplantation
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The Effectiveness of a Hybrid Exercise Program on the Physical Fitness of Frail Elderly
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Background
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“Copyright © 2023 Wolters Kluwe respectively) [40].”
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“However, slow gait speed, low physical activity, weight loss and cognitive impairment are still regarded as strong indicators of frailty.(47) All of these factors may also reflect poor nutritional status, and additional studies on associations between nutrition and frailty are needed to address the challenges of frail…”
Apathy as Marker of Frail Status
Semprini, R., Lubrano, A., Misaggi, G., & Martorana, A. (2012) · Journal of Aging Research · doi:10.1155/2012/436251 · Cited by 18
Identification and assessment of frailty in older patients with chronic myeloid leukemia and myelofibrosis, and indications for tyrosine kinase inhibitor treatment
Breccia, M., Palandri, F., Luciano, L., Benevolo, G., Bonifacio, M., Caocci, G., Castagnetti, F., Palumbo, G. A., Iurlo, A., & Landi, F. (2018) · Annals of Hematology · doi:10.1007/s00277-018-3258-0 · Cited by 17
Medical Crises in Older People: cohort study of older people attending acute medical units, developmental work and randomised controlled trial of a specialist geriatric medical intervention for high-risk older people; cohort study of older people with mental health problems admitted to hospital, developmental work and randomised controlled trial of a specialist medical and mental health unit for general hospital patients with delirium and dementia; and cohort study of residents of care homes and interview study of health-care provision to residents of care homes
Gladman, J. R. F., Harwood, R., Conroy, S., Logan, P., Elliott, R. A., Jones, R. G., Lewis, S., Dyas, J., Schneider, J. M., Porock, D. C., et al. (2015) · Programme Grants for Applied Research · doi:10.3310/pgfar03040 · Cited by 14
Cognitive and gait decrements among non-demented older adults with Type 2 diabetes or hypertension: a systematic review
Niermeyer, M. A. (2017) · The Clinical Neuropsychologist · doi:10.1080/13854046.2017.1414306 · Cited by 14
Falling short: Recruiting elderly individuals for a fall study
Wilding, M., Seegert, L., Rupcic, S., Griffin, M., Kachnowski, S., & Parasuraman, S. R. (2012) · Ageing Research Reviews · doi:10.1016/j.arr.2012.12.002 · Cited by 14
“…encountered in recruitment and sampling (Bergland and Laake, 2005; Brauer et al., 2000; Elley et al., 2007; Ensrud et al., 2007; Faber et al., 2006; Gauchard et al., 2003; Janssen et al., 2004; Lord et al., 2003; Peri et al., 2008; Rothman et al., 2008; Sattin et al., 2005; Smulders et al., 2007).”
Exercise and physical activity for older adults
VanBeveren, P. J., & Avers, D. (2011) · Elsevier eBooks · doi:10.1016/b978-0-323-02948-3.00014-6 · Cited by 14
Non‐Esterified Fatty Acids and Risks of Frailty, Disability, and Mobility Limitation in Older Adults: The Cardiovascular Health Study
Ahiawodzi, P. D., Djoussé, L., Ix, J. H., Kizer, J. R., Tracy, R. P., Arnold, A. M., Newman, A. B., & Mukamal, K. J. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16793 · Cited by 13
Clinical Utility of Frailty Scales for the Prediction of Postoperative Complications. Systematic Review and Meta-Analysis
Rocha, V. P. P. (2017) · PubMed · doi:10.34626/9tdf-a876 · Cited by 13
“There’s More to Frail than That”: Older New Zealanders and Health Professionals Talk about Frailty
Gee, S. B., Cheung, G., Bergler, H. U., & Jamieson, H. A. (2019) · Journal of Aging Research · doi:10.1155/2019/2573239 · Cited by 13
“Camminando e Leggendo ... Ricordo” (Walking and Reading ... I Remember): Prevention of Frailty Through the Promotion of Physical Activity and Reading in People with Mild Cognitive Impairment. Results from the TREDEM Registry
Gallucci, M., Mazzarolo, A. P., Focella, L., Piovesan, C., Mazzetto, M., Ramigni, M., & Marzetti, E. (2020) · Journal of Alzheimer s Disease · doi:10.3233/jad-200542 · Cited by 15
Assessing Physiologic Reserve and Frailty in the Older Emergency Department Patient
Nickel, C. H., & Kellett, J. G. (2023) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2023.05.004 · Cited by 12
Feasibility of a kinect-based system in assessing physical function of the elderly for home-based care
Liu, X., Nikkhoo, M., Wang, L., Chen, C. P. C., Chen, H.-B., Chen, C.-J., & Cheng, C.-H. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-04179-4 · Cited by 15
“It is common to utilize sensors or wearable devices for functional fitness examinations based on the evaluation of the impairment in physical activities [21], and abundant research has utilized different techniques and approaches for this purpose.”
Predictive Strategies to Reduce the Risk of Rehospitalization with a Focus on Frail Older Adults: A Narrative Review
Soytaş, R. B., Levinoff, E. J., Smith, L., Döventaş, A., Morais, J., Veronese, N., & Soysal, P. (2023) · Epidemiologia · doi:10.3390/epidemiologia4040035 · Cited by 12
“%) and weakness (54%), which are diagnostic criteria for sarcopenia [118].”
Background
Cognitive frailty and its association with disability among Chinese community-dwelling older adults: a cross-sectional study
Kong, L., Xie, W., Dong, Z., Liu, Y., Zhao, H., Fan, J., Qi, X.-J., & Li, J. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-04773-0 · Cited by 12
“Rothman et al. also reported that self-reported exhaustion was initially associated with chronic disability after adjustment for socio-demographic factors and comorbidities, but the association was no longer statistically significant after adding the other frailty criteria as covariates [34].”
Background
Frailty in relation to sedentary behaviours and moderate-vigorous intensity physical activity
Blodgett, J. M., Theou, O., Kirkland, S., Andreou, P., & Rockwood, K. J. (2014) · Reviews in Clinical Gerontology · doi:10.1017/s0959259814000124 · Cited by 12
Outpatient grip strength measurement predicts survival, perioperative adverse events, and nonhome discharge among patients with vascular disease
Reeve, T. E., Craven, T. E., Goldman, M. P., Hurie, J., Velázquez-Ramírez, G. A., Edwards, M. S., & Corriere, M. A. (2020) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2020.03.060 · Cited by 11
Prevalence of frailty in older people in Veneto (Italy)*
Battaggia, A., Scalisi, A., Novelletto, B. F., Fusello, M., Michieli, R., & Cancian, M. (2019) · Journal of Drug Assessment · doi:10.1080/21556660.2018.1563549 · Cited by 11
Association Between Angiotensin-Converting Enzyme Insertion/Deletion Polymorphisms and Frailty Among Chinese Older People
Chen, S., Hao, Q., Yang, M. J., Yue, J., Cao, L., Liu, G., Zou, C., Ding, X., Pu, H., & Dong, B. (2015) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2015.01.094 · Cited by 11
A dataset for the automatic assessment of functional senior fitness tests using kinect and physiological sensors
Bernardino, A. J. M., Vismara, C., Badia, S. B. I., Gouveia, É. R., Baptista, F., Carnide, F., Oom, S., & Gamboa, H. F. S. (2016) · International Conference on Technology and Innovation in Sports, Health and Wellbeing (TISHW) · doi:10.1109/tishw.2016.7847782 · Cited by 11
Individual frailty phenotype components and mortality in adults with type 2 diabetes: A UK Biobank study
Mickute, M., Zaccardi, F., Razieh, C., Sargeant, J. A., Smith, A. C., Wilkinson, T. J., Young, H. M. L., Webb, D. R., Khunti, K. K., Davies, M. J., et al. (2022) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2022.110155 · Cited by 10
Triad of impairment in older people with diabetes-reciprocal relations and clinical implications
Abdelhafiz, A. H., Davies, P. C., & Sinclair, A. J. (2020) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2020.108065 · Cited by 11
Construction of a Frailty Indicator with Partially Ordered Sets: A Multiple-Outcome Proposal Based on Administrative Healthcare Data
Silan, M., Signorin, G., Ferracin, E., Listorti, E., Spadea, T., Costa, G., & Boccuzzo, G. (2020) · Social Indicators Research · doi:10.1007/s11205-020-02512-7 · Cited by 15
Caregiving Needs Are Unmet for Many Older Homeless Adults: Findings from the HOPE HOME Study
Semere, W., Kaplan, L. M., Valle, K. A., Guzman, D., Ramsey, C., Garcia, C. M., & Kushel, M. (2022) · Journal of General Internal Medicine · doi:10.1007/s11606-022-07438-z · Cited by 11
Physical performance as a predictor of mortality in nursing home residents: A five-year survival analysis
Holanda, C. M. D. A., Nóbrega, P. V. D. N., & Maciel, Á. C. C. (2022) · Geriatric Nursing · doi:10.1016/j.gerinurse.2022.07.002 · Cited by 12
Falling Short: The Contribution of Central Insulin Receptors to Gait Dysregulation in Brain Aging
Case, S. L., Frazier, H. N., Anderson, K. L., Lin, R., & Thibault, O. (2022) · Biomedicines · doi:10.3390/biomedicines10081923 · Cited by 10
Standardization of the Fried frailty phenotype improves cardiovascular disease risk discrimination
Boreskie, K. F., Kehler, D. S., Costa, E. C., Hiebert, B. M., Hamm, N. C., Moffatt, T. L., Hay, J. L., Stammers, A. N., Kimber, D. E., Kent, D. E., et al. (2019) · Experimental Gerontology · doi:10.1016/j.exger.2019.01.021 · Cited by 10
Presence of Geriatric Conditions Is Prognostic of Major Bleeding in Older Patients with Atrial Fibrillation: a Cohort Study
Wang, W., Saczynski, J. S., Lessard, D., Goldberg, R. J., Parish, D. C., Helm, R. H., Kiefe, C. I., Trymbulak, K., Mehawej, J., Abu, H. O., et al. (2022) · Journal of General Internal Medicine · doi:10.1007/s11606-022-07410-x · Cited by 10
“We also examined how geriatric conditions could improve the current paradigm of bleeding risk stratification and inform the risks and benefits discussions of anticoagulant prescription among older patients with AF.”
BackgroundInfluential
From Sarcopenia to Depressive Symptoms in Elderly: A Path Analysis
Ustevic, C., Rajović, N., Stanisavljevic, D. M., Tiosavljević, D., Pavlović, A., Tasic, R., Rajović, T., Grupkovic, J., Pilipović, F., Pejin, V., et al. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20020972 · Cited by 11
“It is considered that the presence of cognitive impairment and depressive symptomatology in frailty syndrome is associated with a serious decline in functional health and carries out an increased risk of institutionalization and mortality [53].”
Background
The Effect of Non-invasive Brain Stimulation on Gait in Healthy Young and Older Adults: A Systematic Review of the Literature
Baharlouei, H., Salehinejad, M. A., Talimkhani, A., & Nitsche, M. A. (2023) · Neuroscience · doi:10.1016/j.neuroscience.2023.01.026 · Cited by 10
Does a falling level of activity predict disability development in community-dwelling elderly people?
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Gait Speed as a Guide for Blood Pressure Targets in Older Adults: A Modeling Study
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Mobility limitation as a predictor of inpatient care in the last year of life among community-living older people
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Re-amputation and survival following toe amputation: outcome data from a tertiary referral centre
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Self‐reported exhaustion associated with physical activity among older adults
Tsutsumimoto, K., Doi, T., Shimada, H., Makizako, H., Yoshida, D., Uemura, K., Anan, Y., Park, H., & Suzuki, T. (2015) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.12528 · Cited by 9
Criterios de fragilidad en personas mayores que viven en la comunidad: una actualización de la literatura
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Repérage du haut risque de mortalité durant la première année qui suit une hospitalisation en médecine aiguë chez les patients de plus de 65 ans : revue de la littérature
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The relationships between step count and hospitalisation‐associated outcomes in acutely hospitalised older adults – A systematic review
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The Validity and Reliability of the Kaigo-Yobo Checklist in Korean Elderly
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Pulmonary rehabilitation improves frailty and gait speed in some ambulatory patients with chronic lung diseases
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Frailty in CKD—Is Only Seeing Worth Believing?
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Effects of the bio-psycho-social frailty dimensions on healthcare utilisation among elderly in Europe: A cross-country longitudinal analysis
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Does Walking Speed Predict Postoperative Morbidity?
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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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