Fried et al used 5 measures to evaluate older adults for evidence of frailty. This can help identify geriatric patients who may benefit from closer monitoring or more aggressive management. The authors are from the Uniformed Services University of Health Sciences in Bethesda, Maryland, and Wake Forest University in Winston-Salem, North Carolina.
Study: Cardiovascular Health Study (CHS)
Patient selection: men and women >= 65 years of age
Parameters:
(1) unintended weight loss
(2) complaints of exhaustion during past week
(3) physical activity in kcal per week, based on the Minnesota Leisure Time Activity Questionnaire
(4) time to walk 15 ft (4.6 meters) in seconds
(5) grip strength in kilograms
|
Statement About Exhaustion |
Response |
Points |
|
everything feels like an effort |
rarely or none of the time |
0 |
|
|
occasionally |
1 |
|
|
some days |
2 |
|
|
most days |
3 |
|
cannot get going |
rarely or none of the time |
0 |
|
|
occasionally |
1 |
|
|
some days |
2 |
|
|
most days |
3 |
|
Parameter |
Finding |
Points |
|
unintended weight loss |
<= 10 pounds (4.545 kg) |
0 |
|
|
> 10 pounds |
1 |
|
exhaustion |
maximum response for either question 0 or 1 |
0 |
|
|
maximum response for either question 2 or 3 |
1 |
|
physical activity in kcal per week |
female and >= 270 kcal |
0 |
|
|
female and < 270 kcal |
1 |
|
|
male and >= 383 kcal |
0 |
|
|
male and < 383 kcal |
1 |
|
time to walk 15 feet |
male, <= 173 cm tall, < 7 seconds |
0 |
|
|
male, <= 173 cm, >= 7 seconds |
1 |
|
|
male, > 173 cm tall, < 6 seconds |
0 |
|
|
male, > 173 cm, >= 6 seconds |
1 |
|
|
female, <= 159 cm tall, < 7 seconds |
0 |
|
|
female, <= 159 cm, >= 7 seconds |
1 |
|
|
female, > 159 cm tall, < 6 seconds |
0 |
|
|
female, > 159 cm, >= 6 seconds |
1 |
|
grip strength in kilograms |
male, BMI <= 24, grip > 29 kg |
0 |
|
|
male, BMI <= 24, grip <= 29 kg |
1 |
|
|
male, BMI 24.1 to 28, grip > 30 kg |
0 |
|
|
male, BMI 24.1 to 28, grip <= 30 kg |
1 |
|
|
male, BMI > 28, grip > 32 kg |
0 |
|
|
male, BMI > 28, grip <= 32 kg |
1 |
|
|
female, BMI <= 23, grip > 17 kg |
0 |
|
|
female, BMI <= 23, grip <= 17 kg |
1 |
|
|
female, BMI 23.1 to 26, grip > 17.3 kg |
0 |
|
|
female, BMI 23.1 to 26, grip <= 17.3 kg |
1 |
|
|
female, BMI 26.1 to 29, grip > 18 kg |
0 |
|
|
female, BMI 26.1 to 29, grip <= 18 kg |
1 |
|
|
female, BMI > 29, grip > 21 kg |
0 |
|
|
female, BMI > 29, grip <= 21 kg |
1 |
An unintentional weight loss of >= 5% previous body weight was also used to indicate weight loss.
percent unintended weight loss =
= ((body weight last year) - (current body weight)) / (weight last year) * 100%
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• A score >= 3 indicates that the person is frail.
• A score of 1 or 2 indicates an intermediate frailty, with increased risk for becoming frail in 3-4 years.
Purpose: To evaluate an older patient >= 65 years of age for evidence of frailty using the measures of Fried et al.
Specialty: Sports Medicine & Rehabilitation
Objective: clinical diagnosis, including family history for genetics, disability and performance
ICD-10: ,
