Johns Hopkins Adjusted Clinical Groups (ACG)

The Johns Hopkins Adjusted Clinical Groups (ACG) are a frailty-defining indicator.

Item	Criteria
malnutrition	severe protein-calorie malnutrition (marasmus, other
dementia	with delusions, delirium or depression
severe vision impairment	both eyes affected
decubitus ulcer
incontinence of urine
weight loss	abnormal weight loss; underweight; feeding difficulties
fecal incontinence
social support needs	housing insecurity; inadequate material resources
difficulty in walking	abnormality of gait
falls	fall from wheelchair; fall on steps or stairs

where:

• Weight loss should be unintended. Usually there is a threshold for loss over a specified period of time.

If present then the item was scored 1, else 0.

total score =

= SUM(points for all of the parameters present)

Interpretation:

• minimum score: 0

• maximum score: 10

• A score >= 1 indicates frailty.

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