Frailty index

At the 2017 American Gerontological Congress, held in San Francisco, it was pointed out that quite a few gerontologists and geriatricians talked about how, in a general sense, to assess the proximity of ageing.

In this context, the concept of body-wide 'frailty' has been introduced as a complex characteristic of the body's condition. The assessment of whether it is time to "sound the alarm" (read: treatment) consists of fatigue, weakness, walking speed, blood hormone levels, etc. – a set of fairly easy to measure signs in any country, a sure step towards an accessible, reversible but revealing diagnosis.

The frailty index approach first focuses on the number of health deficits and then on the nature of those deficits.

One of the strengths of this approach is that the frailty index can be constructed using existing clinical and population data: not every frailty index needs to include the same items to produce closely comparable estimates of the prevalence and rate of change. The frailty index is reproducible across databases because it takes advantage of the high redundancy of the human body as a state variable.

The main problem is that at least 30 health status variables need to be included; if data have not yet been collected, collecting 30 or more variables can be burdensome. In addition, comorbidities must be taken into account, otherwise a patient with lower limb paralysis may have a lower index of weakness and therefore be considered less weak than a person with advanced cancer affecting several body systems.

Frailty indices have been constructed in various population-based studies around the world, such as the American National Health and Nutrition Examination Survey, the European Health, Ageing and Retirement Study, the Australian Longitudinal Study of Ageing, the Beijing Longitudinal Study of Ageing, and the Mexican Study of Ageing. Health and Ageing Study and the Global Ageing and Adult Health Study (China, Ghana, India, Mexico, Russia and South Africa). Weakness in Canada has been extensively researched using data from the Canadian Survey of Health and Ageing (CSHA) and the National Population Health Survey (NPHS).