Frailty: Toward a Clinical Definition

high rd in vulllow eted hod While most clinicians believe they can recognize a older person, there is a lack of consensus as to what frailty and how it should be diagnosed clinically. 1,2 For this reason, a Geriatric Advisory Panel of the International A emy of Nutrition and Aging has postulated a new approa defining frailty and a case-finding tool. 3 The major agreemen of the group was that for frailty to be a useful clinical tion, it should be considered a predisability state. T stressed that, conceptually, frailty should exclude persons w disability (ie, physical impairment that interferes with ability to perform activities of daily living). Most definitions of frailty have considered it to be a where there is increased vulnerability to stressors. 1,4,5,6 When a frail individual is exposed to a stressor, it is postulate they are at increased risk of developing disability or adverse outcomes (like death, hospitalization, or instituti alization). Thus, the frailty syndrome is part of a contin situated between the normal physiological changes of a and the final state of disability and death. Commonly used definitions of frailty include the F criteria. These criteria, which have been widely embrac include exhaustion (fatigue), weight loss, measured g strength and walking speed, and low energy expenditure. lack of standards for some of the measurements, the diffi in performing these tests in frail older persons especially i nursing home, 8 and the failure of this group to exclude ability have limited the incorporation of these evidence-b criteria into general clinical practice. Rockwood and colleagues 9 have created a frailty ind based on disability and illnesses. It appears to be predict death and institutionalization. 10 It may also predict po outcomes in the nursing home. The Short Physical Performance Battery (gait speed, peated chair stands, and tandem balance) was found t predictive of disability in nondisabled community living