A global clinical measure of fitness and frailty in elderly people

Rockwood, Kenneth; Song, Xiaowei; MacKnight, Chris; Bergman, Howard; Hogan, David B.; McDowell, Ian; Mitnitski, Arnold
August 2005
CMAJ: Canadian Medical Association Journal;8/30/2005, Vol. 173 Issue 5, p489
Academic Journal
Background There is no single generally accepted clinical definition of frailty. Previously developed tools to assess frailty that have been shown to be predictive of death or need for entry into an institutional facility have not gained acceptance among practising clinicians. We aimed to develop a tool that would be both predictive and easy to use. Methods We developed the 7-point Clinical Frailty Scale and applied it and other established tools that measure frailty to 2305 elderly patients who participated in the second stage of the Canadian Study of Health and Aging (CSHA). We followed this cohort prospectively; after 5 years, we determined the ability of the Clinical Frailty Scale to predict death or need for institutional care, and correlated the results with those obtained from other established tools. Results The CSHA Clinical Frailty Scale was highly correlated (r = 0.80) with the Frailty Index. Each 1-category increment of our scale significantly increased the medium-term risks of death (21.2% within about 70 mo, 95% confidence interval [CI] 12.5%-30.6%) and entry into an institution (23.9%, 95% CI 8.8%-41.2%) in multivariable models that adjusted for age, sex and education. Analyses of receiver operating characteristic curves showed that our Clinical Frailty Scale performed better than measures of cognition, function or comorbidity in assessing risk for death (area under the curve 0.77 for 18-month and 0.70 for 70-month mortality). Interpretation Frailty is a valid and clinically important construct that is recognizable by physicians. Clinical judgments about frailty can yield useful predictive information.


Related Articles

  • Physical Activity and Mortality in Frail, Community-Living Elderly Patients. Landi, Francesco; Cesari, Matteo; Onder, Graziano; Lattanzio, Fabrizia; Gravina, Ester Manes; Bernabei, Roberto // Journals of Gerontology Series A: Biological Sciences & Medical ;Aug2004, Vol. 59 Issue 8, p833 

    Background. The authors describe the prevalence of moderate-intensity physical activity in a population of older persons living in the community. In addition, they explore the relationship between physical activity and mortality. Methods. In this longitudinal observational study, the authors...

  • Effect of Exercise Using a Horse-Riding Simulator on Physical Ability of Frail Seniors. MITANI, YASUHIRO; DOI, KAZUYA; YANO, TORU; SAKAMAKI, EIJI; MUKAI, KOUICHI; SHINOMIYA, YOUICHI; KIMURA, TETSUHIKO // Journal of Physical Therapy Science;2008, Vol. 20 Issue 3, p177 

    The article presents information on a study conducted on the effect of exercise using a horse-riding simulator on the physical ability of frail seniors. It is stated that seniors should participate in an exercise program to improve their physical ability. It is mentioned that exercise using a...

  • Health promotion in older adults. Struck, Bryan D.; Ross, Karen M. // Geriatrics;May2006, Vol. 61 Issue 5, p22 

    Some degree of physical activity is always preferable to a sedentary lifestyle. For home bound elderly, with limited mobility and strength, physical activity should be focused on "functional fitness" such as performing activities of daily living, transfers, and mobility. Progressive resistance...

  • Something About Frailty. Morley, John E.; Perry III, H. Mitchell; Miller, Douglas K. // Journals of Gerontology Series A: Biological Sciences & Medical ;Nov2002, Vol. 57 Issue 11, pM698 

    Editorial. Provides information on frailty which indicates older persons at increased risk for morbidity and mortality. Intrinsic factors responsible for the pathogenesis of frailty; Social factors which determine frailty's severity; Precursor conditions that can lead to the major determinants...

  • Conceptualisation and Measurement of Frailty in Elderly People. Rockwood, K.; Hogan, D.B.; MacKnight, C. // Drugs & Aging;2000, Vol. 17 Issue 4, p295 

    The use of the term ‘frailty’ has shown tremendous growth in the last 15 years, but this has not been accompanied by a widely accepted definition, let alone agreed-upon measures. In this paper, we review approaches to the definition and measurement of frailty and discuss the...

  • Putting function first. KritchevskY, S.; Williamson, J. // Journal of Nutrition, Health & Aging;May2014, Vol. 18 Issue 5, p467 

    An introduction to the journal is presented in which the editor discusses the Geriatric Frailty Clinic for older adults who are at risk of disability.

  • frail older people: participation in care. Tutton, Elizabeth // Nursing Older People;Nov2003, Vol. 15 Issue 8, p18 

    The article describes an action research project designed to explore the views of patients and staff on the participation of frail older people in their care in Great Britain. The process of negotiation involved working through daily plans of care and balancing patients' wishes with the staff's...

  • How effective are ROM exercises in frail elderly?  // Brown University Long-Term Care Quality Advisor;02/13/97, Vol. 9 Issue 3, p6 

    Looks at a study published in the `Journal of the American Medical Association' which evaluated the effectiveness of physical rehabilitation for very frail elderly nursing home residents. Components of the physical therapy; Lack of significant improvement in the physical therapy group.

  • Share good care. Leifer, Dina // Nursing Standard;8/24/2005, Vol. 19 Issue 50, p26 

    Although around two thirds of hospital patients are aged 65 and over, services are not always geared to their particular needs. Now 40 projects are up and running around the country to improve situation. INSET: Bite-size education makes a difference.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics