Fried et al identified a number of factors associated with frailty in an elderly patient. The authors are from the Johns Hopkins University, National Institute of Aging, Mid-Atlantic Permanente Medical Group, and Wake Forest University in Winston-Salem
Frailty is viewed as a distinct state that requires multiple problems. No single problem defines frailty and different frail elders may have different problems.
Baseline population: adult >= 65 years of age
Core elements (see CHS Index, above):
(1) generalized weakness
(2) poor endurance
(3) weight loss, which may be associated with anorexia or undernutrition
(4) low physical activity
(5) slow gait
The presence of 3 or more core elements is sufficient to classify a patient as frail.
Additional characteristics:
(1) age > 90 years (although a person may be fit after 90, many people over 90 will undergo a gradual decline)
(2) functional dependence (requires assistance in some activities of daily living)
(3) prolonged bed rest
(4) gait disorder with risk or fear of falling
(5) delirium, confusion, memory loss or other cognitive compromise
(6) homebound
(7) polypharmacy
Features I might add (some from Table 2, page 257):
(1) incontinence
(2) difficulty bending over
(3) inability to climb up steps
(4) difficulty standing for any length of time
(5) impaired vision and/or hearing
(6) difficulty speaking or holding a conversation
(7) tendency to "dose off"
