Table 1

The Frailty Phenotype

Frailty Phenotype componentMeasure
Unintentional weight loss≥10 pounds or ≥ 5% body weight over the preceding 12 months.
WeaknessHand grip strength will be assessed in the seated position with the elbow positioned at 90°, supported by the arm of a chair, and with a hand grip dynamometer (Takei 5101 GRIP-A dynamometer, Takei Scientific Inst. Co. Ltd. Niigata, Japan) supported by the assessor. Both arms will be examined with the highest score from three efforts from each side used for analysis. The body mass index and gender stratified hand grip strength cut-offs proposed by Fried et al are used to define weakness.2
SlownessWalking speed (15 feet) will be assessed as outlined in the section titled ‘Physical Function’. The height and gender stratified walking speed cut-offs proposed by Fried et al are used to define slowness.2
Low physical activityA modified version of the Minnesota Leisure Time Questionnaire55 will be used to assess physical activity. Low physical activity is defined as <383 kcal/week for men and <270 kcals/wk for women.2
Self-perceived exhaustionThe CES-D Scale will be used to assess self-perceived exhaustion.56 Participants will be read the following statements: (1) I felt that everything I did was an effort. (2) I could not get going. Participants will then be asked, ‘How often in the last week did you feel this way?’ and provided the following scale: 0=rarely or none of the time, 1=some of the time, 2=moderate amount of the time, 3=most of the time. Self-perceived exhaustion is defined as an answer ≥2 for either statement2.
Frailty is diagnosed if three or more frailty components are present.
Prefrailty is diagnosed if one or two frailty components are present.
  • CES-D, Center for Epidemiological Studies Depression.