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Related Experiment Video

Updated: Jan 28, 2026

Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty

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

Discrepancy in Frailty Identification: Move Beyond Predictive Validity.

Qian-Li Xue^1,2, Jing Tian^2,3, Jeremy D Walston¹

¹Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

|February 22, 2019

Summary

This summary is machine-generated.

Frailty classification differs significantly between the physical frailty phenotype (PFP) and frailty index (FI). These instruments cannot be used interchangeably in clinical practice.

Keywords:

Construct validation Cumulative deficits Geriatric syndrome Measurement Vulnerability

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Area of Science:

Gerontology
Geriatric Medicine
Public Health

Background:

Frailty is a key indicator of health status in older adults.
Two common measures of frailty are the physical frailty phenotype (PFP) and the frailty index (FI).
Understanding discordance between these measures is crucial for accurate health assessment.

Purpose of the Study:

To evaluate classification discrepancies between the PFP and FI in older adults.
To identify factors associated with discordant frailty classifications.
To compare agreement levels between the PFP and FI.

Main Methods:

A prospective observational study of 5,362 older adults (≥65 years) across four US communities.
Frailty assessed using the Cardiovascular Health Study PFP (≥3 of 5 criteria = frail).
Frailty Index (FI) calculated from 48 deficits (FI > 0.35 = frail).

Main Results:

Frailty prevalence was 7.0% (PFP) and 8.3% (FI).
Only 12% of frail individuals agreed between PFP and FI; 39% were PFP-frail only, 48% were FI-frail only.
Younger participants (65-72) and those with higher disease burden were more likely FI-frail but not PFP-frail.
Frailty associations with age and mortality were stronger with PFP than FI.

Conclusions:

Substantial discordance exists in individual frailty classification between PFP and FI despite similar prevalence.
Highest agreement was observed only in the most vulnerable individuals.
PFP and FI are not interchangeable in clinical settings due to significant classification differences.