New approach assesses frailty in older adults on a continuum

A national team led by a University of Pittsburgh School of Public Health epidemiologist present a new way to consider frailty: As a continuum.

The results, published in the The Journals of Gerontology: Series A, can guide clinicians in evaluating apparently healthy older adults by using challenging tests of endurance, strength and speed to better monitor their patients' health, or assess their need for medical care or ability to recover from surgery.

Using data from the Study of Muscle, Mobility and Aging (SOMMA) of 879 men and women aged 70 and older, the researchers developed the SOMMA Vigor to Frailty Score, a noninvasive assessment of oxygen consumption, leg power and other measures, to rank older adults from 0 (vigorous) to 12 (frail). Patients on the high end of the continuum were up to 31 times more likely to have functional limitations that impact activities of daily living and mobility than their vigorous counterparts.

"Frailty in older adults is a way to describe their vulnerability and age-related decline in health. It is related to disability, but it can be present in older adults without any apparent disabilities. It is in these apparently healthy people that frailty is most challenging to identify," said Anne Newman, M.D., M.P.H., distinguished professor of epidemiology at Pitt Public Health and clinical director of the Aging Institute at Pitt and UPMC.

"By determining where patients fall on the continuum of frailty to vigor, we hope to better predict their resilience to stress, such as recovery from surgery."