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Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
Frailty in older adults: evidence for a phenotype
L P Fried1, C M Tangen, J Walston
1Center on Aging and Health, The John Hopkins Medical Institutions, Baltimore, Maryland 21205, USA. lfried@welch.jhu.edu
Summary
Frailty in older adults is a distinct syndrome, not synonymous with disability. A new definition identifies those at risk, enabling early clinical assessment and intervention development for improved health outcomes.
Area of Science:
- Gerontology
- Clinical Medicine
- Public Health
Background:
- Frailty is highly prevalent in older adults, increasing risks for falls, disability, hospitalization, and mortality.
- While previously considered synonymous with other conditions, frailty may be a distinct clinical syndrome with a biologic basis.
- A standardized definition for frailty is currently lacking.
Purpose of the Study:
- To develop and operationalize a frailty phenotype in older adults.
- To assess the concurrent and predictive validity of this frailty definition.
- To explore the relationship between frailty, comorbidity, and disability.
Main Methods:
- Utilized data from the Cardiovascular Health Study, including 5,317 community-dwelling men and women aged 65 and older.
- Collected baseline evaluations and followed participants for 4-7 years, monitoring for incident disease, hospitalization, falls, disability, and mortality.
- Defined frailty based on criteria including unintentional weight loss, exhaustion, weakness, slow walking speed, and low physical activity.
Main Results:
- The prevalence of frailty was 6.9%, increasing with age and higher in women. Four-year incidence was 7.2%.
- Frailty was associated with African American ethnicity, lower socioeconomic status, poorer health, and higher comorbidity and disability rates.
- The frailty phenotype independently predicted falls, mobility/ADL disability, hospitalization, and death, with intermediate frailty status indicating increased risk.
Conclusions:
- A potential standardized definition for frailty in community-dwelling older adults was established with concurrent and predictive validity.
- An intermediate frailty stage was identified, signaling individuals at high risk.
- Frailty is distinct from comorbidity and disability; comorbidity is a risk factor, and disability is an outcome.
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