Frailty Phenotype

Sep 10, 20151 like1,269 views

This document provides criteria for assessing frailty in older adults based on a frailty phenotype. It measures five domains: grip strength, walking speed, physical activity levels, self-reported exhaustion, and unintentional weight loss. Individuals are categorized as nonfrail if no criteria are present, prefrail if one or two are present, and frail if three or more are present based on specified cut-off values that differ for men and women. References are provided for the frailty phenotype assessment tool and overview information on frailty syndrome.

Frailty Phenotype
FRAILTY CRITERIA PRESENT
NOT
PRESENT
Poor Grip Strength
Meets criteria for frailty if grip strength (average of 3
trials, dominant hand) is:
Men
 ≤ 29 kg for BMI ≤ 24
 ≤ 30 kg for BMI 24.1–26
 ≤ 30 kg for BMI 26.1–28
 ≤ 32 kg for BMI >28
Women
 ≤ 17 kg for BMI ≤ 23
 ≤ 17.3 kg for BMI 23.1–26
 ≤ 18 kg for BMI 26.1–29
 ≤ 21 kg for BMI > 29
Slow Walking Speed
Meets criteria for frailty if walking speed (average of 2
15 feet trials) is:
Men
 ≥ 7 seconds for height ≤ 173 cm
 ≥ 6 seconds for height > 173 cm
Women
 ≥ 7 seconds for height ≤ 159cm
 ≥ 6 seconds for height > 159cm
Low Level of Physical Activity
Meets criteria for frailty if physical activity level per
week is:
 Men: ≤ 383 kcals
 Women: ≤ 270 kcals
 Based on the following activities:
o Walking for exercise, moderately
strenuous household chores, mowing or
raking the lawn, gardening, hiking,
jogging, biking, exercise cycle, dancing,
aerobics, bowling, golf, singles or doubles
tennis, racquetball, calisthenics,
swimming
 kcals expended per week formula:
o kcal/week = [activity-specific MET
(kcal/kg × hour) ] × [duration per session
(min) / 60 min] × [body weight (kg)] ×
[number of sessions per week]

Self-reported Exhaustion
Meets criteria for frailty if answer is “moderate or most
of the time” for either question:
 I felt that everything I did was an effort in the last
week:
o Rarely or none of the time (<1 day)
o Some or little of the time (1 to 2 days)
o Moderate amount of the time (3 to 4 days)
o Most of the time
 I could not get going in the last week:
o Rarely or none of the time (<1 day)
o Some or little of the time (1 to 2 days)
o Moderate amount of time (3 to 4 days)
o Most of the time
Unintentional Weight Loss
Meets criteria for frailty if patient lost > 10 lb
unintentionally in the last year
TOTAL:
FRAIL CATEGORY
 Nonfrail: No criteria factors present.
 Prefrail: 1 or 2 criteria factors present.
 Frail: 3 or more criteria factors present.
References
American Geriatrics Society. (2012). Geriatrics evaluation & management tools. Retrieved from
http://familymed.uthscsa.edu/gerifellowship/redirect/articles/CLC/Geriatrics%20Eval%20Manageme
nt%20Tool%20for%20Frailty.pdf
American Physical Therapy Association, (2011). Physical therapist’s guide to sarcopenia and frailty
[Website]. Retrieved from
http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=a5b541cf-6cd4-406890bb-
cdc13753b2b1#.VW36Oc9Vikp
Chen, X., Mao, G., & Leng, S. X. (2014). Frailty syndrome: An overview. Clinical Interventions in Aging, 9,
433-441. doi:10.2147/CIA.S45300
Fried LP, Tangen CM, Walston J, et al. (2001). Frailty in older adults: Evidence for a phenotype. Journal of
Gerontology: Medical Sciences, 56A:3, M146–M156.

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Frailty Phenotype

1. Frailty Phenotype FRAILTY CRITERIA PRESENT NOT PRESENT Poor Grip Strength Meets criteria for frailty if grip strength (average of 3 trials, dominant hand) is: Men  ≤ 29 kg for BMI ≤ 24  ≤ 30 kg for BMI 24.1–26  ≤ 30 kg for BMI 26.1–28  ≤ 32 kg for BMI >28 Women  ≤ 17 kg for BMI ≤ 23  ≤ 17.3 kg for BMI 23.1–26  ≤ 18 kg for BMI 26.1–29  ≤ 21 kg for BMI > 29 Slow Walking Speed Meets criteria for frailty if walking speed (average of 2 15 feet trials) is: Men  ≥ 7 seconds for height ≤ 173 cm  ≥ 6 seconds for height > 173 cm Women  ≥ 7 seconds for height ≤ 159cm  ≥ 6 seconds for height > 159cm Low Level of Physical Activity Meets criteria for frailty if physical activity level per week is:  Men: ≤ 383 kcals  Women: ≤ 270 kcals  Based on the following activities: o Walking for exercise, moderately strenuous household chores, mowing or raking the lawn, gardening, hiking, jogging, biking, exercise cycle, dancing, aerobics, bowling, golf, singles or doubles tennis, racquetball, calisthenics, swimming  kcals expended per week formula: o kcal/week = [activity-specific MET (kcal/kg × hour) ] × [duration per session (min) / 60 min] × [body weight (kg)] × [number of sessions per week]

2. Self-reported Exhaustion Meets criteria for frailty if answer is “moderate or most of the time” for either question:  I felt that everything I did was an effort in the last week: o Rarely or none of the time (<1 day) o Some or little of the time (1 to 2 days) o Moderate amount of the time (3 to 4 days) o Most of the time  I could not get going in the last week: o Rarely or none of the time (<1 day) o Some or little of the time (1 to 2 days) o Moderate amount of time (3 to 4 days) o Most of the time Unintentional Weight Loss Meets criteria for frailty if patient lost > 10 lb unintentionally in the last year TOTAL: FRAIL CATEGORY  Nonfrail: No criteria factors present.  Prefrail: 1 or 2 criteria factors present.  Frail: 3 or more criteria factors present. References American Geriatrics Society. (2012). Geriatrics evaluation & management tools. Retrieved from http://familymed.uthscsa.edu/gerifellowship/redirect/articles/CLC/Geriatrics%20Eval%20Manageme nt%20Tool%20for%20Frailty.pdf American Physical Therapy Association, (2011). Physical therapist’s guide to sarcopenia and frailty [Website]. Retrieved from http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=a5b541cf-6cd4-406890bb- cdc13753b2b1#.VW36Oc9Vikp Chen, X., Mao, G., & Leng, S. X. (2014). Frailty syndrome: An overview. Clinical Interventions in Aging, 9, 433-441. doi:10.2147/CIA.S45300 Fried LP, Tangen CM, Walston J, et al. (2001). Frailty in older adults: Evidence for a phenotype. Journal of Gerontology: Medical Sciences, 56A:3, M146–M156.

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Frailty Phenotype

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