| Frailty Instrument | Seed Publication | Number of citing articles, through Dec 2013 (from Web of Science) | Items | Scoring |
|
Physical Frailty Phenotype (commonly called the frailty phenotype, Fried phenotype, or CHS frailty phenotype)
|
| | |
|
Fried LP, et al, J. Gerontol. A. Biol. Sci. Med. Sci, 2001
|
Link
|
|
1891
|
| |
|
Walking Speed (measured walking tests)
|
|
Activity (physical activity questionnaire)
|
|
Weight Loss (unintentional weight loss)
|
|
Exhaustion (questions on energy expenditure)
|
|
Grip Strength (measured grip strengths tests)
|
|
Score range: 0 to 5.
Frail = =3 criteria present;
Intermediate/pre-frail = 1-2 criteria present
Robust = 0 criteria present
|
|
Deficit Accumulation Index (commonly called the Frailty index)
|
| | |
|
Mitnitski AB, et al, ScientificWorldJournal, 2001
|
Link
|
|
Mitnitski AB, et al, J Gerontol A Biol Sci Med Sci, 2004
|
Link
|
|
Rockwood K, et al, J Am Geriatr Soc, 2006
|
Link
|
|
Rockwood K et al, J Gerontol A Biol Sci Med Sci, 2007
|
Link
|
|
Rockwood K & Mitnitski A, J Gerontol A Biol Sci Med Sci, 2007
|
Link
|
|
401
|
| |
|
Diseases, ADLs, health attitudes and values, signs
|
|
Symptoms from clinical and neurological exams
|
|
For a full list:
|
|
http://myweb.dal.ca/amitnits/
|
|
CSHAclinical-variables.jpg
|
|
Number of deficits present and divided by the number of deficits taken into consideration.
Higher proportion equates to a higher level of frailty.
|
|
Gill Frailty Measure
|
| | |
|
Gill TM, et al, N Engl J Med, 2002
|
Link
|
|
254
|
|
Moderately frail if rapid gait speed back and forth over 10ft course is >10s; or could not stand from the chair.
Severely frail if meet both criteria.
Non frail if can complete both tasks.
|
|
Frailty / Vigor assessment
|
| | |
|
Speechley M & Tinetti M, J Am Geriatr Soc, 1991
|
Link
|
|
246
|
| |
|
Frail:
|
|
age (over 80)
|
|
decreased / abnormal physical function
|
|
infrequent physical activity
|
|
psychological function (depressed)
|
|
medications (taking sedatives)
|
|
lower extremity disability
|
|
sensory function (near vision loss)
|
|
Vigorous:
|
|
age (under 80)
|
|
frequent physical activity
|
|
cognitively intact
|
|
sensory function (good near vision)
|
|
Score ranges:
Frail 0-9
Vigorous 0-4
Frail: =4 frail values and =1 vigor value
Vigorous: =3 vigor values and =2 frail values
Transitional: having median values for either or both frail (3) and vigor
|
|
Clinical Frailty Scale
|
| | |
|
Rockwood K, et al, CMAJ, 2005
|
Link
|
|
239
|
| |
|
Please see the scoring column.
|
|
1 = Very fit
|
|
2 = Well
|
|
3 = Well, with treated comorbid disease
|
|
4 = Apparently vulnerable
|
|
5 = Mildly frail
|
|
6 = Moderately frail
|
|
7 = Severely frail
|
|
Physician assigns score of 1 to 7 based on clinical judgment. Physicians making the initial assessment given access to diagnoses and assessments related to these variables and other measures of comorbidity, function and associated features that inform clinical judgments about the severity of frailty. A secondary review and scoring performed by a multidisciplinary team. Access is available to health variables measured for patient to inform judgment.
|
|
Brief Frailty Instrument
|
| | |
|
Rockwood K, et al, Lancet, 1999
|
Link
|
|
226
|
| |
|
4 levels of classification, fitness to frailty:
|
|
See scoring column.
|
|
0 = walk without help, perform basic ADL, are continent of bowel and bladder, and are not cognitively -impaired; 1 = bladder incontinence only; 2 = one (two if incontinent) or more of needing assistance with mobility or activities of daily living, has CIND, or has bowel or bladder incontinence; 3 = two (three if incontinent) or more if totally dependent for transfers or 1+ activities of daily life, incontinent, and dementia.
Higher classification means higher grade of frailty.
|
|
Vulnerable Elders Survey
(VES-13)
|
| | |
|
Saliba D, et al, J Am Geriatr Soc, 2001
|
Link
|
|
225
|
| |
|
Age
|
|
Self-rated health
|
|
Physical function
|
|
ADL / IADL disability
|
|
Score range: 0 to 10.
Frail = score 3+
|
|
FRAIL Scale
|
| | |
|
Abellan van Kan G, et al, J Am Med Dir Assoc, 2008
|
Link
|
|
Abellan van Kan G, et al, J Nutr Health Aging, 2008
|
Link
|
|
211
|
| |
|
Fatigue
|
|
Resistance (ability to climb 1 flight of stairs)
|
|
Ambulation (ability to walk 1 block)
|
|
Illnesses (greater than 5)
|
|
Weight Loss (>5%)
|
|
Score range 0 to 5. No frailty = 0 deficits. Intermediate frailty = 1 or 2 deficits. Frailty = 3 or more deficits.
|
|
Winograd Screening Instrument
|
| | |
|
Winograd CH, et al, J Am Geriatr Soc, 1991
|
Link
|
|
198
|
| |
|
Cerebrovascular accident
|
|
Chronic and disabling illness
|
|
Confusion
|
|
Dependence in ADLs
|
|
Depression
|
|
Falls
|
|
Impaired Mobility
|
|
Incontinence
|
|
Malnutrition
|
|
Polypharmacy
|
|
Pressure sore
|
|
Prolonged bedrest
|
|
Restraints
|
|
Sensory Impairment
|
|
Socioeconomic / family problems
|
|
Frail = presence of any one of the 15 screening criteria.
Participants could instead be categorized as “Severely impaired” if they had severe dementia and ADL dependence, or terminal illness
|
|
Physical Frailty Criteria
|
| | |
|
Binder EF, et al , J Am Geriatr Soc, 2002
|
Link
|
|
185
|
| |
|
Self-reported difficulty with IADLs or ADL.
|
|
Modified PPT
|
|
V02 peak
|
|
Two or more criteria met = mild to moderate physical frailty
|
|
FI-CGA (Frailty Index based on Comprehensive Geriatric Assessment)
|
| | |
|
Jones DM et al, J Am Geriatr Soc, 2004
|
Link
|
|
Jones D et al, Aging Clin Exp Res, 2005
|
Link
|
|
154
|
| |
|
mood and motivation
|
|
communication
|
|
mobility
|
|
balance
|
|
bowel function
|
|
bladder function
|
|
IADLs and ADLs
|
|
nutrition
|
|
social resources
|
|
cognitive status
|
|
FI-CGA score = addition of the count of CGA-identified problems from the 10 domains, plus the comorbidity count of active diagnoses.
|
|
1994 Frailty Measure
|
| | |
|
Strawbridge WJ, et al, J Gerontol, 1998
|
Link
|
|
154
|
| |
|
16 items to represent the following 4 domains:
|
|
physical functioning
|
|
nutritive functioning
|
|
cognitive functioning
|
|
sensory problems
|
|
A score of "3" or higher on at least one item in any domain was considered as a problem or difficulty in that particular domain. Participants were classified as frail in 1994 if they reported having problems or experiencing difficulty in two or more domains.
|
|
Gait speed as a single frailty measure
|
| | |
|
Abellan Van Kan G, et al, J Nutr Health Aging, 2009
|
Link
|
|
152
|
| |
|
Gait speed (walking speed)
|
|
Gait speed < .2 m/s is cut point for extreme frailty. Gait speed < .8 m/s is cut point for increased risk of adverse health outcomes.
|
|
Study of Osteoporotic Fractures (SOF) index
|
| | |
|
Ensrud KE, et al, Arch Intern Med, 2008
|
Link
|
|
133
|
| |
|
Weight loss
|
|
Self-report energy
|
|
Chair rise
|
|
Out of 3 criteria for frailty:
=2 = frail.
1 = intermediate or pre-frail.
0 = robust.
|
|
Chin A Paw instrument
|
| | |
|
Chin A Paw MJ, et al, J Clin Epidemiol, 1999
|
Link
|
|
111
|
| |
|
Physical activity
|
|
Food and beverage intake
|
|
Weight loss
|
|
BMI
|
|
Functional status
|
|
Health characteristics
|
|
Physical inactivity combined with: (1) an energy intake less than 7.6 (lowest quartile) MJ per day; (2) a 5-year weight loss more than 4kg (lowest quartile of weight change); or (3) a BMI less than 23.5 kg/m2 (lowest quartile). Physical inactivity was defined as less than 210 minutes (lowest quartile) of physical activity per week.
|
|
Survey of Health, Aging and Retirement in Europe (SHARE) Frailty Index (FI) - SHARE-FI
|
| | |
|
Santos-Eggimann et al, J Gerontol, 2009
|
Link
|
|
Romero-Ortuno R, BMC Geriatr, 2010
|
Link
|
|
106
|
| |
|
Frailty Phenotype approach with major modification
|
|
Exhaustion: 1 self-report question
|
|
Shrinking: reported diminution in desire for food
|
|
Weakness: grip strength
|
|
Walking speed: mobility questions
|
|
Low activity: self-report
|
|
One point for each fulfilled criterion; individuals with 0 points were classified as nonfrail; with 1-2 points as prefrail; and with 3-5 points as frail.
|
|
Modified Physical Performance Test (PPT)
|
| | |
|
Brown M, et al, J Gerontol, et al, 200
|
Link
|
|
102
|
| |
|
Book lift
|
|
Put on and take off coat
|
|
Pick up penny
|
|
Chair rise
|
|
Turn 360 degrees
|
|
50 ft. walk
|
|
Climb one flight of stairs
|
|
Climb four flights of stairs
|
|
Progressive Romberg test
|
|
Score range on the PPT: 0-36 points
Not frail: 32–36.
Mildly frail: 25–31.
Moderately frail: 17–24.
|
|
Groningen Frailty Indicator (GFI)
|
| | |
|
Steverink N, Gerontologist, 2001
|
Link
|
|
Schuurmans H, et al, J Gerontol, 2004
|
Link
|
|
96
|
| |
|
Physical (mobility functions, multiple health prob
|
|
Cognitive (cognitive functioning)
|
|
Social (emotional isolation)
|
|
Range from zero to fifteen that assesses the physical, cognitive, social, and psychological domains. A GFI score of four or greater is considered the cut-off point for frailty (“moderately frail”)
|
|
MDS-CHESS
|
| | |
|
Hirdes JP et al, J Am Geriatr Soc. 2003
|
Link
|
|
96
|
|
|
|
Clinical Global Impression of Change in Physical Frailty (CGIC-PF) instrument
|
| | |
|
Studenski S, et al, J Am Geriatr Soc, 2004
|
Link
|
|
95
|
|
|
|
Grip Strength as single measure
|
| | |
|
Syddall H, et al, Age Ageing, 2003
|
Link
|
|
93
|
|
|
|
Modified Frailty Phenotype, with Cognition
|
| | |
|
Rothman MD, J Am Geriatr Soc, 2008
|
Link
|
|
92
|
| |
|
Slow gait speed
|
|
Low physical activity
|
|
Weight loss
|
|
Exhaustion
|
|
Weakness
|
|
Cognitive Impairment
|
|
Depressive symptoms
|
|
|
|
Static / Dynamic Frailty instrument
|
| | |
|
Puts MT, et al, J Am Geriatr Soc, 2005
|
Link
|
|
87
|
|
|
|
Edmonton Frail Scale
|
| | |
|
Rolfson DB, et al, Age Ageing, 2006
|
Link
|
|
81
|
|
|
|
Modified Frailty Phenotype
|
| | |
|
Avila-Funes, et al, J Am Geriatr Soc, 2009
|
Link
|
|
66
|
| |
|
Weight Loss
|
|
Slowness
|
|
Exhaustion
|
|
Physical Activity
|
|
3+ out of 5 = frail
1-2 out of 5 = prefrail
0 out of 5 = nonfrail
|
|
Health Status Questionnaire empirical method
|
| | |
|
Brody KK, et al, Gerontologist, 1997
|
Link
|
|
55
|
|
Frailty is dependent dichotomous variable determined by whether or not the subject has been placed in nursing home; received long-term care; and/or been eligible to receive these services within 365 days of the receipt of the HSF
|
|
Sherbrooke Postal Questionnaire
|
| | |
|
Hébert R et al, Age Ageing, 1996 (Hebert)
|
Link
|
|
54
|
| |
|
Health problems that limit activities
|
|
Age / Sex
|
|
Live alone
|
|
Hospitalized in last year
|
|
|
|
Easy Prognostic Score for Frailty Outcomes in the Aged
|
| | |
|
Ravaglia G, Age Ageing, 2008
|
Link
|
|
51
|
|
|
|
Modified version of the Functional Independence Measure (FIM) instrument
|
| | |
|
Carlson JE, et al, Am J Phys Med Rehabil, 1998
|
Link
|
|
51
|
| |
|
Feeding
|
|
Hygiene
|
|
Bathing
|
|
Toileting
|
|
Dressing
|
|
Communication
|
|
Mobility
|
|
Classification of subjects by functional homeostasis was defined dichotomously as no decline in FIM™ score versus a decline of one point or greater. Frail = having a decline in FIM score.
|
|
Balducci Criteria
|
| | |
|
Pal SK, CA Cancer J Clin, 2010
|
Link
|
|
49
|
|
|
|
Tilburg Frailty Indicator (TFI)
|
| | |
|
Gobbens RJ, et al, J Am Med Dir Assoc, 2010
|
Link
|
|
45
|
| |
|
Weight loss
|
|
Walking
|
|
Hand strength
|
|
Tiredness
|
|
Physical health
|
|
Balance
|
|
Vision
|
|
Hearing
|
|
Cognition
|
|
Depressive symptoms
|
|
Anxiety
|
|
Coping
|
|
Living alone
|
|
Social relations
|
|
Social support
|
|
Scoring range 0-15, with a score of 0 or 1 per item. 15 equates to highest level of frailty.
|
|
Frailty Staging System
|
| | |
|
Cacciatore F, et al, Eur J Clin Invest, 2005
|
Link
|
|
44
|
| |
|
Disability
|
|
Mobility
|
|
Cognition
|
|
Visual
|
|
Hearing
|
|
Continence
|
|
Social Support
|
|
Score of 0 or 1 in each domain.
Class 1 frailty = 0-1
Class 2 frailty = 2-3
Class 3 frailty = 4-7
|
|
Comprehensive Assessment of Frailty (CAF)
|
| | |
|
Sündermann S, et al, Eur J Cardiothorac Surg, 2011 (Sundermann)
|
Link
|
|
44
|
|
|
|
Macarthur Study of Successful Aging (MSSA) Extended Phenotype
|
| | |
|
Sarkisian CA, J Am Geriatr Soc, 2008
|
Link
|
|
35
|
|
|
|
Multi-dimensional frailty score (combined and modified Fried and Rockwood items)
|
| | |
|
Hubbard RE et al, Age Ageing, 2009
|
Link
|
|
29
|
| |
|
Weight loss
|
|
Grip strength
|
|
MMSE
|
|
Timed get-up-and-go
|
|
FEV
|
|
|
|
Dayhoff instrument
|
| | |
|
Dayhoff NE, et al, J Gerontol Nurs, 1998
|
Link
|
|
24
|
| |
|
ADL/IADLs (WHO Assessment of Functional Capacity)
|
|
Self-reported perceived health
|
|
Score range: 14 (self-sufficiency) to 70 (total dependency)
Non-frail if score =20 & excellent/good health. Frail if score =21 & fair/poor health.
|
|
Frail Elderly Functional Assessment (FEFA) questionnaire
|
| | |
|
Gloth FM, et al, Am J Phys Med Rehabil, 1995
|
Link
|
|
21
|
| |
|
Mobility
|
|
Toileting
|
|
Meals
|
|
Dressing
|
|
Bathing
|
|
Basic Mechanical Skills
|
|
Finances
|
|
Communication
|
|
Medications
|
|
Scores range from 0-55. Low score infers better function.
|
|
Klein Frailty Index
|
| | |
|
Klein BE, et al, Trans Am Ophthalmol Soc, 2003
|
Link
|
|
20
|
|
|
|
G8, as a frailty assessment instrument
|
| | |
|
Bellera CA, et al, Ann Oncol, 2012
|
Link
|
|
17
|
|
|
|
Short Physical Performance Battery (SPPB) as frailty instrument
|
| | |
|
Bandinelli S, et al, Aging Clin Exp Res, 2006
|
Link
|
|
16
|
|
Score range on the Short Physical Performance Battery (SPPB) is 0-12 (0-4 on each of 3 tests)
Frailty defined as score =9.
|
|
Hebrew Rehabilitation Center for Aged (HRCA) vulnerability index, as a frailty assessment instrument
|
| | |
|
Kanauchi M et al, Int J Clin Pract, 2008
|
Link
|
|
15
|
|
|
|
COOP-WONCA (COOP functional health assessment charts – World Organization of Family Doctors) screener
|
| | |
|
Van Hout et al, J Gerontol, 2010
|
Link
|
|
14
|
|
|
|
Score-risk scale for dependency
|
| | |
|
Carrière I, et al, J Clin Epidemiol, 2005
|
Link
|
|
14
|
| |
|
Mobility (gait speed, chair stand)
|
|
Balance (tandem position test)
|
|
Nutrition (BMI)
|
|
Muscle strength (grip test)
|
|
Physical Activity
|
|
Perceived health
|
|
Education level
|
|
Age
|
|
Time since last evaluation
|
|
Score, between 25-165, corresponds to risk for dependency coefficient
|
|
PRISMA-7
|
| | |
|
Hébert R, et al, Can Fam Physician, 2003
|
Link
|
|
13
|
|
|
|
British Frailty Index
|
| | |
|
Kamaruzzaman S et al, Health Qual Life Outcomes, 2010
|
Link
|
|
12
|
|
|
|
Frailty Cluster Analysis Method
|
| | |
|
Passarino G, Biogerontology, 2007
|
Link
|
|
11
|
|
|
|
Frailty as subjective immediate impression of general health appearance
|
| | |
|
Gerdhem P, et al, Gerontology, 2003
|
Link
|
|
11
|
| |
|
General health appearance
|
|
General assessment of health and appearance within 15 seconds from first sight, transferred this into an arbitrary scale, from 1–100, where ‘1’ represented an individual not frail at all and ‘100’ a very frail or aged individual. 2 raters per individual overall.
|
|
Brief frailty index (for clinical use with coronary artery disease patients)
|
| | |
|
Freiheit EA, et al, J Am Geriatr Soc 2010
|
Link
|
|
11
|
| |
|
Body composition
|
|
Balance
|
|
Cognition
|
|
Mood
|
|
Social Isolation
|
|
Domains dichotomized as abnormal (=1) or normal (=0).
Score range 0-5, with higher score = higher risk of frailty.
|
|
Clinical judgment criteria for dependence on another person for daily care
|
| | |
|
Brody KK, et al, J Am Geriatr Soc, 2002
|
Link
|
|
11
|
|
|
|
Guilley instrument
|
| | |
|
Guilley E, et al, Research on Aging, 2008
|
Link
|
|
10
|
| |
|
Mobility
|
|
Memory
|
|
Energy
|
|
Physical pains
|
|
Sensory capacities
|
|
Frail = deficiencies in two or more domains; Robust = one or zero affected domains.
|
|
Gérontopôle Frailty Screening Tool (Gerontopole)
|
| | |
|
Subra J, et al, J Nutr Health Aging, 2012
|
Link
|
|
10
|
|
|
|
Simple prognostic frailty risk score
|
| | |
|
Pijpers E, et al, Postgrad Med J, 2009
|
Link
|
|
8
|
|
|
|
Physical Performance Frailty Tests
|
| | |
|
Lee JS, et al, J Nutr Health Aging, 2011
|
Link
|
|
7
|
|
|
|
Schoenenberger index
|
| | |
|
Schoenenberger AW, Eur Heart J, 2013
|
Link
|
|
6
|
|
|
|
Geriatric Functional Evaluation (GFE) questionnaire
|
| | |
|
Scarcella P, et al, Arch Gerontol Geriatr, 2005
|
Link
|
|
5
|
|
|
|
Gealey instrument
|
| | |
|
Gealey SG, et al, J Am Acad Nurse Pract, 1997
|
Link
|
|
5
|
|
ADL: 0–10; IADL: 0–14; combination of ADL/IADL: 0–24. Dichotomous: frail–not frail. Frail/non-frail determination made by gerontological nurse practitioners, then compared to ADL, IADL and combined scores.
|
|
Marigliano-Cacciafesta polypathological scale (MCPS)
|
| | |
|
Amici A, et al, Arch Gerontol Geriatr. 2008
|
Link
|
|
5
|
|
Polypathology (as measure of fragility or frailty or comorbidity):
Score range: 0 to 245
Slight: <15
Medium: 15–24
Medium-severe: 25-49
Severe: 50-74
Very severe: =75
|
|
Opasich assessment
|
| | |
|
Opasich C, et al, Eur J Cardiovasc Prev Rehabil, 2010
|
Link
|
|
4
|
|
|
|
Self-Report Frailty Screening Instrument
|
| | |
|
De Souto Barreto, et al, Arch Gerontol Geriatr, 2012
|
Link
|
|
3
|
| |
|
Low BMI
|
|
Low level of physical activity
|
|
Dissatisfaction with muscle strength
|
|
Dissatisfaction with energy endurance
|
|
Score range 0-4.
Frail: =3
Pre-frail: 1-2
Robust: 0
|
|
Physical, Mental and Social Frailty Indices
|
| | |
|
Garre-Olmo J, et al, Age Ageing, 2013
|
Link
|
|
2
|
| |
|
see: http://ageing.oxfordjournals.org/content/
|
|
suppl/2012/03/06/afs047.DC1
|
|
Deficit accumulation model, excluding disability.
|
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Barber Questionnaire, as frailty screening test
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Molina-Garrido MJ and Guillen-Ponce C, Crit Rev Oncol Hematol, 2011
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Link
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2
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Simple assessments: clinical judgment; polypharmacy; self-rated health
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Hoogendijk EO et al, Age Ageing, 2013
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Link
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1
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Subscale of SF-20 as frailty assessment
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Haken et al, Scand J Caring Sci, 2002
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Link
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1
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Very demanding physical activities
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Less demanding activities
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Walking stairs or a hill
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Bending or kneeling
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Walking
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Eating or dressing
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Physical frailty was measured using a six item functioning scale, which was a subscale of the MOS Short-form General Health Survey, SF-20. Physical frailty was determined if participants had restraints in at least three of the six physical activities.
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Evaluative Frailty Index for Physical Activity (EFIP)
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de Vries NM, et al, Phys Ther, 2013
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Link
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1
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Physical functioning
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Psychological functioning
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Social functioning
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General health
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Score range 0-50.
Score calculated by total points divided by 50. Higher score indicates higher level of frailty.
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Comprehensive Frailty Assessment Instrument
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De Witte N, et al, Geriatr Nurs, 2013
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Link
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0
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Physical (4 indicators)
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Psychological (5 mood and 3 emotional indicators)
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Social (3 social and 3 social support indicators)
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Environmental (5 home/neighborhood indicators)
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Score range 0-23.
Higher score indicates higher level of frailty.
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Accelerometry-based frailty assessment
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Fontecha J, et al, J Med Internet Res, 2013
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Link
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0
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Easycare Two-step Older persons Screening (TOS)
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van Kempen JA, et al, Br J Gen Pract, 2013
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Link
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0
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