· Web viewEach deficit is dichotomized (present or absent) or trichotomized and coded in the interval 0 to 1. The total score is the number of deficits present divided by

SUPPLEMENTARY MATERIAL

Table A.1: Descriptive properties of frailty instruments

In this table the identified frailty instruments are described in detail in terms of 1. Cohort type and Frailty domains assessed, 2. Scoring system used to determine frailty status, 3. Frailty operationalization (objective versus self-reported frailty items) and 4. Frailty prevalence

Frailty instrument/study Cohort studied and description of frailty instrument

Scoring Type of assessment

Prevalence offrailty

MULTI-DOMAIN Frailty Instruments70-item Frailty Index/Canadian Study of Health and Aging CSHA (Rockwood et al., 2005, 2006, 2007)

2005- CSHA wave 2 composed of 2305 living in the community and in institutions.2006 – CSHA wave 1 composed of 1174 community dwellers and aged 69-71 years at baseline.2007 – CSHA wave 2 consisting of 728 institutionalized older adults.Count of accumulated deficits consisting of currently active diseases, ability in ADLs, physical signs from clinical and neurological examinations.

Each deficit is dichotomized (present or absent) or trichotomized and coded in the interval 0 to 1. The total score is the number of deficits present divided by 70. The composite score ranges between 0 and 1. Although FI is not meant to be dichotomized into frail/non-frail empirical cut-off points of 0.2 and 0.25 have been used. Usually frailty is conceptualized as a continuum and so higher scores indicate worse frailty.

Objective and self-reported

-

40-item Frailty Index/CSHA (Rockwood et al., 2006)

1174 community dwellers aged 69-71 years at baseline.Count of accumulated deficits consisting of ability in ADLs and diseases.

The total score is the number of deficits present divided by the total number of deficits. Higher scores indicate worse frailty.

Self-reported -

50-variable Frailty Index derived from Canadian Study of Health and Aging CSHA-FI (Joseph et al., 2014)

100 trauma patients aged 65 years and older.Frailty index composed of 50 pre-admission variables based on the following domains: co-morbidities, daily activities, health attitude, function, and nutrition.

Each variable is given a score of 0, 0.25, 0.5, 0.75 or 1. FI is calculated as a ratio of the total number of deficits present divided by the total number of variables, 50. Higher FI represents higher likelihood of frail state.

Self-reported -

Modified Frailty Index mFI (Hodari et al., 2013)

2095 patients undergoing oesophagectomy.Derived by mapping 16 variables within National Surgical Quality Improvement Program NSQIP database to 11 corresponding items in the CSHA-FI.

The total score is the number of deficits present divided by the total number of deficits. Higher scores indicate worse frailty and increased morbidity and mortality post oesophagectomy.

Self-reported -

38-item Burden model/ Health and Retirement Study HRS(Cigolle et al., 2009)

11,113 community dwellers and nursing home residents aged 65 years and over.38 deficits (not specified) derived from the 70 item FI.

Each deficit is scored as 1 and the index is calculated by dividing the number of deficits present by the total number of deficits. The composite score ranges from 0 to 1. A score ≥ 0.2 implies frailty.

- 32%

40- item Rockwood Frailty Index RFI/ Newcastle 85+ study(Collerton et al., 2012)

845 community dwellers and nursing home residents aged 85 years and over.Count of 40 potential deficits including activities of daily living, diseases, geriatric syndromes, symptoms, cognitive function, self-rated health and ECG abnormalities.

Total scoring range: 0-1 (computed from the 40 deficits). Higher scores indicate worse frailty.


-

51-variable / Gothenburg H-70 study (Rockwood et al., 2006; original Steen BH, Djurfeldt H, 1993)

966 elderly aged 70 years and older.51 clinically designated symptoms, signs, diseases and disabilities.

Each deficit that is present is given a score of 1. The total score is calculated by adding all the deficits present and dividing by the total number of deficits possible. Higher scores indicate worse frailty.


-

Modified 43-item Armstrong Index (Hogan et al., 2012; original Armstrong et al., 2010)

1066 assisted living and supportive housing facilities residents.Count of 43 out of the original 50 items, depending on availability in interRAI-AL tool consisting of mood, communication, functional status, diseases, health conditions, nutrition and medications.

The total score is based on a count of accumulated deficits divided by number of potential deficits.Robust < 0.2, pre-frail 0.2 – 0.3, frail > 0.3

Self- reported 52.3%

83-item Full Frailty Index (Hogan et al., 2012)

1066 assisted living and supportive housing facilities residents.Count of 83 items derived from interRAI-AL consisting of psychosocial well-being, mood, cognition, communication, functional status, diseases, health conditions, nutrition and medications.

The total score is based on a count of accumulated deficits divided by number of potential deficits.Robust < 0.2, pre-frail 0.2 – 0.3, frail > 0.3

Self-reported 28.7%

48-item Deficits index DI (Kulminski et al., 2008)

4721 elderly involved in the CHS aged 65 years and over. Count of 48 deficits based on signs, symptoms, impairments and diseases

The total score is based on a count of accumulated deficits divided by number of potential deficits.Robust ≥0 - ≤0.2, pre-frail >0.2- ≤0.35, frail > 0.35


19.8%

32-item Frailty Index – Cumulative Deficits FI-CD (Pilotto et al., 2012; original Ensrud et al., 2009)

2033 hospitalized patients aged 65 years and older.Count of 32 deficits consisting of health problems, diseases and activities of daily living.

The total score is based on a count of accumulated deficits divided by number of potential deficits.

Self- reported -

62-item Frailty Index (Woo et al., 2006)

2032 elderly aged 70 years and older.62 variables covering cognitive, psychological and physical health.


Self-reported -

47-item Frailty Index FI(Woo et al., 2012)

4000 community-dwellers aged 65 years and older.Count of 47 items consisting of health conditions, diseases, functional, physical, psychological and cognitive



-

44- item Deficit Accumulation Index DAI (Hastings et al., 2008)

1851 community dwellers aged 65 years and older.Count of 44 deficits consisting of health problems, diseases, and functional problems.

The total score is based on a count of accumulated deficits divided by number of potential deficits.Quartile cut-points for DAI scores: 0.14, 0.23, 0.36.

Self-reported -

43-item Frailty Index/ Conselice Study of Brain Aging(Lucicesare et al., 2010; original Jones et al., 2004)

1016 elderly aged 65 years and older residing in the Conselice municipality.43 health deficits including symptoms, signs, co-morbidities and functional impairments (not specified) collected as part of the comprehensive geriatric assessment.

Each deficit is scored as 1 and the index is calculated by dividing the number of deficits present by the total number of deficits. The composite score ranges from 0 to 1. A score of 0.25 implies a clinically important level of frailty.

Items of the frailty index not specified

-

CSHA rules-based definition of frailty based on GSS/ Composite B/ Deficit Accumulation Index DAI derived from CGA (Purser et al, 2006; Salvi et al.,

309 elderly aged 70 years and older admitted to a cardiology service (composite B)200 elderly aged 65 years and older who

Four levels representing fitness to frailty.(0) Those who walk without help, perform basic activities of daily living (eating, dressing, bathing, bed transfers), are continent of bowel

Self-reported Composite B: 63%DAI: 58.5%CSHA rules

2012; original Rockwood et al., 1999)

attended the emergency department.9008 community dwellers aged 65 years and older (DAI)Based on limitations in mobility, activities of daily living, incontinence and cognitive impairment.

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; and(3) two (three if incontinent) or more of totally dependent for transfers or one or more activities of daily life, incontinent of bowel and bladder, and diagnosis of dementia.

based definition of frailty:Level 0 – 67%Level 1 – 12%Level 2 – 16%Level 3 – 5%

Canadian Study of health and Aging Clinical Frailty Scale CSHA – CFS(Rockwood et al., 2005, 2007)

CSHA wave 2 consisting of 2305 elderly aged 70 years and older living in the community as well as in institutions.Use of simple clinical descriptors including ability in ADLs, presence of active diseases, presence of symptoms, and physical fitness.

7 levels representing fitness to frailty based on judgment of physician(1) Very fit(2) Well(3) Well with treated co-morbid disease(4) Apparently vulnerable(5) Mildly frail(6) Moderately frail(7) Severely frailScoring range: 1-7.

Self-reported Level 1 - 9.37%Level 2 - 11.28%Level 3 - 20.65%Level 4 - 15.14%Level 5 - 13.23%Level 6 - 21.56%Level 7 - 8.42%

Chinese-Canadian Study of Health and Aging Clinical Frailty Scale Telephone Version CSHA-CFS TV(Chan et al., 2010)

67 community-dwelling elderly aged 65 years and older attending outpatient clinics in Taiwan.Adapted from CSHA-CFS physician version whereby the physician fills out a global impression of frailty after CGA (comprehensive geriatric assessment). CSHA-CFS TV is a telephone interview consisting of 17 questions. It uses a step-by-step approach whereby first the severely frail subjects are screened out and then the other levels of frailty (6-1) are subsequently identified. It is based on activities of daily living (basic and instrumental), slowness, fitness and diseases.

7 categories representing fitness to frailty. Severely frail (7) – complete dependency in ADL.Moderately frail (6) – assistance in at least 1 ADL and 1 IADL.Mildly frail (5) – only 1 IADL impairmentApparently vulnerable (4) – yes to the question ‘do you feel slowed up recently?’ + poor controlled symptoms of chronic diseasesWell with treated co-morbid diseases (3) - yes to the question ‘do you feel slowed up recently?’ + well controlled symptoms of chronic diseasesWell (2) – no to the question ‘do you think that you are fitter compared to someone of your age?’Very fit (1) - yes to the question ‘do you think

Self-reported Category 3 – 22%Category 4 – 40%Category 5 – 28%Category 6 - 8%Category 7 – 2%

that you are fitter compared to someone of your age?’

Frailty Index Comprehensive Geriatric Assessment FI CGA (Pilotto et al., 2012; original Jones et al., 2004)

2033 hospitalized patients aged 65 years and older.Impairments in 10 domains: cognitive status, mood and motivation, communication, balance, bowel and bladder functions, impairments in ADL, nutrition, social resources.

For each domain: 0=no problem, 1=minor problems, 2=major problem. 3 grades of frailty: mild 0-7, moderate 7-13, severe >13

Objective and subjective

Mild – 69.7%Moderate – 29.2%Severe – 1.1%

Multidimensional Prognostic Index MPI based on CGA (Pilotto et al., 2012; original Pilotto et al., 2008)

2033 hospitalized patients aged 65 years and older.Based on the comprehensive geriatric assessment and includes impairments in 8 domains: bADL, IADL, cognitive, co-morbidity, nutrition, risk of developing pressure sores, number of drugs, cohabitation status

For each domain a tripartite hierarchy was used (0=no problems, 0.5=minor problems, 1=major problems). The total sum is divided by total number of domains i.e. 8. Final MPI is expressed as three grades of all risk mortality:Low risk ≤0.33, moderate risk 0.34-0.66, severe risk >0.66.


Low risk – 41.9%Moderate risk – 36.5%Severe risk – 21.6%

Adjusted Clinical Groups-diagnoses based computerized predictive model frailty tag ACG frail/outpatient CGA study at Israeli Health Maintenance Organization (Sternberg et al., 2012)

195 elderly aged 65 years and older who underwent CGA in geriatric clinics in Israel.Consists of frailty diagnostic clusters – malnutrition, dementia, impaired vision, decubitus ulcer, incontinence of urine or feces, loss of weight, obesity, poverty, barriers to access of care, difficulty walking

Presence of any frailty cluster is associated with a frailty tag.

Self-reported -

CGA-frailty (Kristjansson et al., 2012; original Balducci, Extermann, 2000, 2005)

176 patients aged 70-94 years electively operated for colon cancer.Multi domain frailty classification based on CGA. Consists of dependency in ≥ 1 ADL, severe co-morbidity (CIRS-score), cognitive dysfunction (MMSE <24), depression (GDS >13), malnutrition (MNA <17), incontinence and medications (>7)

CGA-frailty is present when one or more of the criteria (specified in 2nd column) are fulfilled


43%

HUBBARD scale/Chinese cohort (Woo et al., 2012; original Hubbard

4000 community dwellers aged 65 years and older.

7-point scale ranging from very fit (1) to bed ridden (7).

Self-reported 1.6%

et al., 2010) Similar to original but operationalized according to data available in this Chinese cohort. It is based on walking for exercise, presence of chronic diseases, ADLs and IADLs.

Functional domains model/Health and Retirement Study HRS(Cigolle et al., 2009; original Strawbridge et al., 1998)

11,113 elderly aged 65 years and older living in the community and in nursing homes.It is based on 4 functional domains: physical, nutritive, cognitive and sensory.

Frailty status - ≥2 domains with deficiencies. Objective and self-reported

29%

Onco-Geriatric Screening Tool OGS(Valero et al., 2011)

174 elderly aged 75 years and older newly diagnosed with cancer.It explores 5 frailty risks: autonomy, malnutrition, depression, cognition and co-morbidity.

Each frailty risk is evaluated by 2 criteria with binary response (yes/no). Patient is considered at risk if at least one of their responses to the criteria exploring the risk was positive.Fit (no risk) – would not benefit from CGAVulnerable (1-3 risks) – would benefit from CGAFrail (4-5 risks) - would only benefit from CGA if oncological treatment was decided upon.


8%

Reference test to the Onco-geriatric screening tool (Valéro et al., 2011)

174 elderly aged 75 years and older newly diagnosed with cancer.Same as OGS but operationalized in a different way: autonomy (TUG ≥20s, ≥2 negative IADLs responses), malnutrition (MNA ≤23.5), depression (GDS >9), cognition (MMSE < 26), co-morbidity (≥1 untreated or unstable co-morbid condition or >4 medications).

As OGS Objective and self-reported

10%

Simple Frailty Score (Robinson et al., 2013)

201 patients aged 65 years and older who underwent elective cardiac and colorectal surgery.It is based on 7 frailty characteristics which were measured preoperatively: Timed up and Go and Katz score (function), Mini-cog (cognition), Charlson Index and anemia of chronic disease (chronic disease burden), albumin level

Non-frail ≤1 abnormal frailty characteristicsPre-frail 2 - 3 abnormal frailty characteristicsFrail 4 – 7 abnormal frailty characteristics


28%

(nutrition), geriatric syndromes (falls).Expanded Frailty Model (Amrock et al., 2014)

Patients 65 years and older who underwent elective lower gastrointestinal surgery.It is based on the Robinson’s prospective frailty index with the addition of laboratory markers related to frailty. It includes (National Surgical Quality Improvement Program) NSQIP variables which need to be entered by trained personnel. This consists of measures of poor nutrition and inflammation, muscle mass and chronic renal insufficiency, anemia, cognitive dysfunction, functional disability, fall risk and weakness, physical health and fitness and co morbidity index.

Not specified Objective and self-reported

-

Electronic Frailty Model (Amrock et al., 2014)

Patients 65 years and older who underwent elective lower gastrointestinal surgery.It is a simplified frailty model based solely on variables which are universal to electronic medical records. This includes age, sex, race, serum albumin, hematocrit, serum creatinine and American Society of Anesthesiologists Physical Status (ASA PS) score.

Not specified Objective and self-reported

-

15 variable Trauma- Specific Frailty Index TSFI (Joseph et al., 2014)

200 trauma patients aged 65 years and older.Developed from the 50 variable Frailty Index. It is a questionnaire which assesses the patient’s pre-injury health condition. It is a clinical assessment tool to predict unfavorable discharge disposition in geriatric trauma patients.

The individual variables are given a score of 0 or 1 (or 0.25, 0.5, 0.75 where applicable) and the TSFI score is the sum of individual variables divided by 15. A TSFI score of >27 indicates frailty and is predictive of unfavorable discharge disposition following trauma in geriatric patients.

Self - reported -

CSBA index /Easy Prognostic Indicator (Forti et al., 2012; original

Conselice Study of Brain Aging, 1007 participants aged 65 years and older.

Frailty is equivalent to the presence of ≥3 variables

Objective and self- reported

37.6%

Ravaglia et al., 2008) Consists of 9 variables including age ≥ 80 years, male gender, physical inactivity, sensory deficits, daily use of ≥3 drugs, calf circumference < 31 cm, difficulty in IADL, poor self-perceived health

Conselice Study of Brain Aging Score/Modified easy prognostic score (Lucicesare et al., 2010; original Ravaglia et al., 2008)

Conselice Study of Brain Aging, 1016 participants aged 65 years and older.As original but omitting sex and age.

Not specified. Objective and self-reported

-

Kihon checklist (Fukutomi et al., 2013)

527 community dwellers aged 75 years and older.It is a questionnaire consisting of 25 questions which are divided into 7 categories: IADL, physical function, nutrition, oral function, withdrawing into one’s shell, cognitive function and depression.

The sum of all indices ranged from 0 (no frailty) to 25 (high frailty).Classified into ‘risk group’ or ‘non-risk group’ according to whether they have negative scores in the following domains:‘Low physical strength’- ≥3 negative responses in questions 6-10.‘Low nutritional status’ – negative answers to questions 11 and 12.‘Low oral function’ – ≥2 negative responses to questions 13-15.‘Overall low scores on questions 1-20’ – ≥10 negative responses to questions 1-20.‘Houseboundness’ – negative response to question 16.‘Low cognitive function’ - ≥1 negative responses to questions 18-20.‘Depression risk’ - ≥2 negative responses to questions 21-25.

Self-reported -

Barber Questionnaire (Molina –Garrido, Guillen-Ponce, 2011; original Barber et al., 1980, 1981)

Women aged 65 years and older with early breast cancer.A questionnaire consisting of 9 questions based on social support, function, self- rated health, vision, hearing and hospitalization.

Positive if a patient answers yes to at least one question i.e. a total score of > 0.

Self-reported 41.5%

Sherbrooke Postal Questionnaire(Metzelthin et al., 2010;

Metzelthin: 687 community dwellers aged 70 years and older.

Items can be answered with yes or no. Scores range from 0 to 6. A score of ≥ 2 or higher

Self-reported 59.1%

Daniels et al., 2012; original Hébert et al., 1996)

Daniels: 430 community dwellers aged 70 years and older.Consists of 6 items which focus on the physical (4 items), social (1 item) and cognitive (1 item) domains of functioning.

indicates an increased risk for functional decline and, therefore, are assumed to be frail.

INTER-FRAIL (Di Bari et al., 2014) Community dwellers aged 70 years and older.A 10-item postal questionnaire derived from the Sherbrooke Postal Questionnaire.

Each item had a yes/no answer. When a cut-off score of 4 was reached the participant was referred for a comprehensive geriatric assessment.

Self-reported 43%

Vulnerable Elders Scale VES-13/Acove Frailty Score (Kellen et al., 2010; Molina-Garrido, Guillen-Ponce, 2010; Sternberg et al., 2012; Smets al al., 2014original Saliba et al., 2000, 2001)

Kellen - 113 cancer patients who are 70 years and olderMolina-Garrido - 41 women diagnosed with early breast cancer and who are 65 years and olderSternberg - 195 elderly aged 65 years and older who underwent CGA in geriatric clinics in Israel.Smets - 509 participants aged 70 years and older, one group with a primary diagnosis of breast, prostate, lung or gastrointestinal cancer and the second group without cancer.It is a screening instrument in the form of a questionnaire based on age, self-estimated general health and self-reported functional impairment in six physical activities and five instrumental activities of daily living.

Total score ranges from 0-10. Score of ≥ 3 indicates frailty. Higher scores reflect greater frailty.

Self-reported Kellen - 9%Molina-Garrido -29.3%Sternberg - 83%Smets - 50%

Modified VES-13/Modified Scoring(S. -L. Ma et al., 2009)

230 community dwellers aged 65 years and older.Same as original but excluding age.

Total Scoring range is 12-60, no specific cutoff score that indicates frailty but higher scores indicate higher frailty.General health score: 1-5Function sub score 6-30IADL sub score 11-55

Self-reported -

Groningen Frailty Indicator (GFI) Kellen: 113 cancer patients who are 70 All answer categories are dichotomized and a Self-reported Kellen - 31%

(Kellen et al, 2010; Metzelthin et al, 2010; Daniels et al, 2012; Smets et al., 2014; Olaroiu et al., 2014; original Steverink et al, 2001)

years and older.Metzelthin: 687 community dwellers aged 70 years and older.Daniels: 430 community dwellers aged 70 years and older.Smets: 509 participants aged 70 years and older, one group with a primary diagnosis of breast, prostate, lung or gastrointestinal cancer and the second group without cancer.Olaroiu: 215 Romanian community dwellers aged 65 years and older.Screening tool based on a questionnaire of 15 items based on 4 domains: physical, cognitive, social and psychological.

score of 1 indicates a problem or dependency. A score of ≥ 4 represents moderate to severe frailty.

Metzelthin -46.3%Daniels - 46.3%Smets - 51%Olaroiu – 75%

Self-assessment version of GFI(Peters et al., 2012)

353 community dwelling and institutionalized elderly aged 65 years and older.Same as original except that the questions are modified from patient-oriented to individual-oriented e.g. ‘do you sometimes miss people around yourself?’ to ‘do other people pay attention to you?’

Same as original. Self-reported 60%

Tilburg Frailty Indicator (Daniels et al., 2012;Gobbens et al., 2012;Metzelthin et al., 2010; original Gobbens et al., 2010)

Daniels: 430 community dwellers aged 70 years and older.Gobbens: 484 community dwellers aged 75 years and older.Metzelthin: 687 community dwellers aged 70 years and older.This questionnaire consists of two parts A and B. Part A consists of 10 items and comprises socio-demographic data, data about life-events and chronic diseases.. Part B consists of 15 items and comprises physical (8 items), social (3 items) and psychological factors including cognition (4 items).

Only the items of part B determine the level of frailty. Most of the items can be answered with a ‘yes’ or ‘no’. For the psychological items the option ‘sometimes’ is added. A total score of ≥5 indicates frailty.

Self-reported Daniels - 40.2%Gobbens - not availableMetzelthin - 40.2%

Modified Short Emergency Geriatric Assessment (SEGAm) instrument (Oubaya et al., 2014; original Schoevaerdts et al., 2004))

167 community dwellers aged 65 years and older.It is similar to the original frailty instrument except that the titles of the response modalities have been modified in order to adapt them to the French culture. It is a 13-item questionnaire based on the multi-domain concept of frailty.

Each item may be graded as 0 (most favorable state), 1, or 2 (least favorable state).Not very frail: score ≤ 8Frail: >8 to ≤11Very frail > 11

Self-reported Not frail or not very frail: 70%Frail: 21%Very frail: 9%

Identification of Seniors At Risk ISAR(Salvi et al., 2012; original McCusker et al., 1999)

200 elderly aged 65 years and older who attended the emergency department.It is a short questionnaire consisting of 6 items evaluating the presence or absence of risk factors for adverse outcomes after presentation at the emergency department (ED). It can be used to identify frail elderly in an ED setting.

The total score ranges from 0-6. A cut-off of 2 showed sensitivity of 94% and specificity of 63% in identifying frail ED patients.

Self-reported -

Modified Changes in Health, End-Stage Disease and Symptoms and Signs of medical problems CHESS(Hogan et al., 2012; original Hirdes et al., 2003)

1066 assisted living residents aged 65 years and older.It is a measure of health stability designed to identify individuals at high risk for clinically significant decline.Similar to original but operationalized using items from the inter-RAI AL. It is based on a count of different symptoms. Two items in the original CHESS namely dehydration and decline in food/fluid intake were unavailable in this study so they were not included.

0 – low risk for serious decline1 – intermediate risk for serious decline≥2 – high risk for serious decline

Self-reported 24.2%

CGA (Smets et al., 2014;original Solomon 1988)

509 participants aged 70 years and older, one group with a primary diagnosis of breast, prostate, lung or gastrointestinal cancer and the second group without cancer.It consists of 5 domains: functional status, cognition, depression, nutritional status

A positive score in ≥2 domains indicates frailty.A score of ≥2 in the functional status is positive for that domain.A score of ≤ 23 in the MMSE is positive for that domain.A score of ≥8 in the GDS-15 is positive for that domain.


48%

and medication use. Decline in food intake in previous month or weight loss of ≥1kg in previous 3 months was deemed positive.The use of ≥3medications was deemed positive.

aCGA(Smets et al.,2014;original Overcash et al., 2005)

509 participants aged 70 years and older, one group with a primary diagnosis of breast, prostate, lung or gastrointestinal cancer and the second group without cancer.It is a screening instrument for frailty and it consists of 15 questions covering 3 domains: functional status (7 questions on ADL and IADL), cognitive status (4 questions from MMSE) and depression (4 questions from GDS-15).

A positive score in ≥1 domains indicates frailty.A score of ≥1 in the functional status is positive for that domain.A score of ≤6 in the cognitive status is positive for that domain.A score of ≥2 in depression is positive for that domain.


60%

G8 (Smets al al., 2014; original Soubeyran et al., 2008)

509 participants aged 70 years and older, one group with a primary diagnosis of breast, prostate, lung or gastrointestinal cancer and the second group without cancer.It is a screening instrument for frailty and it consists of 8 questions related to age, functional status, cognitive status, nutrition and medication use.

The maximum score is 17. A score of ≤14 indicates frailty.


55%

Frailty Index for Elders FIFE (Tocchi et al., 2014)

156 individuals newly admitted to an assisted living facility (ALF) and 156 participants newly admitted to home and community –based care programs (HCB). Individuals in both groups were aged 65 years and older.FIFE consists of 10 items based on 5 domains: functional, physiological, psychological, social support and health care use.

Each item was dichotomized into 1 (presence of frailty indicator) or 0 (absence of frailty indicator). The total score is 10. A total score of ≥4 indicates frailty. Higher scores indicate higher degrees of frailty.

Self-reported -

Multidimensional Frailty Score MFS (Kim et al., 2014)

275 elderly aged 65 years and older who underwent intermediate-risk to high-risk

Three CGA items (ADL dependence, dementia and malnutrition were scored 0, 1, or 2 while

Objective and self -reported

-

elective operations.It is based on the comprehensive geriatric assessment CGA and includes 6 domains: burden of co-morbidity, polypharmacy, physical function, psychological status, nutrition, and risk of post-operative delirium.

the three other items (malignant disease, IADL dependence and risk of delirium) were scored 0, 1 depending on the severity of the items assessed. The total score of the MFS is 15. A score of ≥5 indicates higher risk for post-operative mortality.

The Frailty Trait Scale FTS (Garcia-Garcia et al., 2014)

The Toledo Study for Healthy Aging, Spain, 1972 community dwellers aged 65 years and older.The FTS is based on a comprehensive approach to the biological basis of frailty. It includes 7 dimensions including energy balance and nutrition, activity, nervous system, vascular system, weakness, endurance and slowness operationalized through 12 items.

Each item score represents a biological trait and ranges from 0 (best) to 4 (worst) except for the chair stand test which ranges from 0 to 5. The total score is calculated by adding the scores of each item and dividing by the total score and multiplied by 100. Thus 0 represents best score (robust) and 100 represents worst score (frail). A cut- off value of ≥ 50 has been used in this paper.


-

Physical frailty score(Carriere et al., 2005)

545 high functioning women aged 75 years and older.Evaluation of 7 domains: mobility, perceived health, balance, muscle strength, visual acuity, body composition physical activity, educational level, perceived health, fear of falling.

A score which is predictive of risk of dependency is calculated based on the domains present


-

Modified Physical Performance Test + VO₂peak + ADL(Villareal et al., 2004)

156 elderly aged 65 years and older, 52 obese, 52 frail non-obese, 52 non-frail and non-obese.Modified PPT of 9 tasks (as above) plus peak aerobic power and bADL and IADL.

Mild to moderately frail if at least 2 of 3 criteria were met: PPT score 18 – 32, VO₂peak 11 to 18mL/kg per minute, need for assistance for≥ 2 IADL or 1bADL


Mild to moderately frail (obese elderly)- 96%

Modified FRAIL Scale/ Chinese cohort (Woo et al., 2012; Morley J.E. et al., 2012; original Abellan Van Kan et al., 2008)

4000 community dwellers aged 65 years and older.Same to original but operationalized in a different way: fatigue (reporting no energy), resistance (cannot climb up to 10 steps), ambulation (cannot walk 2-3 blocks), illness (same as original), and loss

A score of 1 is assigned to each variable.Robust = 0Prefrail = 1-2Frail = ≥3

Objective and self- reported

14%

of weight (BMI < 18.5kg/m²).Seven potential frailty criteria (Rothman MD et al., 2008)

754 non-disabled community dwellers aged 70 years and older.Operationalization is based on the original 5 physical components plus cognition (MMSE) and depression (11 item CES-D scale).

The independent prognostic effect of each of the 7 components for adverse outcomes (chronic disability, long term nursing home stays, injurious falls, death) was determined


-

SINGLE-DOMAIN Frailty InstrumentsMarigliano-Cacciafesta polypathology scale MCPS (Martocchia et al., 2013; original Amici et al., 2008)

98 patients and 20 controls attending outpatient clinic for assessment of disability. It is a scale which assesses and quantifies the presence of co-morbidities. It consists of 11 co-morbidities.

Each co-morbidity is evaluated for presence and severity (0-25 points).Polypathology is classified as follows based on the total score:Slight <15 scoresMedium 15-24 scoresMedium-severe 25-49 scoresSevere 50-74 scoresVery severe >75 scores

Objective Patients - 97%Controls - 5%

Frailty based on sensor data(Greene et al., 2014)

130 community dwellers aged 65 years and older.Frailty is assessed using a combination of 3 physical tests (timed up and go test, balance and five-times-sit-to-stand)which are objectively measured using inertial sensors and a pressure sensor platform - Wii balance board – for the balance test.

Classification into frail and non-frail using support vector machines.

Objective -

Phenotype of frailty/Cardiovascular Health Study CHS (Kulminski et al., 2008; Makary et al., 2010; Nemoto et al., 2011; Collerton et al., 2012; Kim et al., 2014; original Fried et al., 2001)

Fried – 5317 community dwellers aged 65 years and older.Kulminski – (main cohort of cardiovascular Health Study) 4721 community dwellers aged 65 years and older.Makary- 594 elderly aged 65 years and older who will undergo elective surgery.Nemoto – 400 community dwellers aged 65 years and older.Collerton - 845 community dwellers and nursing home residents aged 85 years

Total score:0 – robust1-2 pre-frail≥3 frail


Fried - 6.9%Kulminski - 7.6Makary - 10.4%Nemoto - 3%Collerton - 21.6%Kim - 31.48%

and older.Kim – 162 males aged 65 years and older who were enrolled in a geriatric clinic.Evaluation of 5 different components: shrinking (weight loss), poor endurance and energy (exhaustion CES-D), low physical activity (Minnesota Leisure Time Activity questionnaire) slowness (slow walking speed), weakness (poor grip strength)

Phenotype of frailty(Modified by Hogan et al., 2012)

1066 assisted living residents aged 65 years and older.Operationalized as original except for slowness (walking speed over 3m) and exhaustion (assessed by 3 random questions).

As original Objective and self-reported

47.9%

Composite A/ Phenotype of frailty(Modified by Purser et al., 2006)

309 inpatients at the cardiology service aged 70 years and older.Operationalized as original except for physical activity (36-item Medical Outcomes Study Short Form Survey physical function subscale).


27%

Phenotype of frailty(Modified by Woo et al., 2012)

4000 community dwellers aged 65 years and older.Operationalized as original except for exhaustion (no energy), weight loss (BMI), and physical activity (PASE).


-

Phenotype of frailty(Modified by Kristjansson et al., 2012)

176 patients aged 70-94 years electively operated for colorectal cancer.Operationalized as original except for weight loss (question B from MNA), slowness (Timed Up and Go), exhaustion and low activity (EORTC QLQ-C30).


13%

Phenotype of frailty(Modified by Ensrud et al., 2007, 2009)

2007: 6724 community dwelling women aged 69 years and older.2009: 3132 community dwelling men


2007 - 16%2009 - 13.9%

aged 67 years and older.Operationalized as original except for low physical activity (Harvard Alumni Questionnaire in 2007 and PASE in 2009) and exhaustion (GDS).

Phenotype of frailty(Modified by Avila-Funes et al., 2009)

6030 community dwelling elderly aged 65 to 95.Operationalized as original except for weight loss (loss of ≥ 3kg or BMI), weakness (difficulty rising from a chair), low physical activity (daily leisure activities or once weekly athletic activities).


7%

Phenotype of frailty /Mobilise Boston Study MBS(Modified by Kiely et al., 2009)

765 community dwellers aged 70 years and older.Operationalized as original except for weakness (sit-stand test time), exhaustion (CESD-R), and low physical activity (PASE).


10%

Phenotype of frailty(Modified by Savva et al., 2013)

1814 community dwellers aged 65 years and older.Operationalized as the original except for gait speed (using electronic walkway system) and physical activity (International Physical Activity questionnaire).


7.7%: ≥65 years13.5%: ≥75 years

Phenotype of frailty/MacArthur Study of Successful Aging MSSA(Modified by Gruenewald et al., 2009)

803 high functioning community dwellers aged 70-79 years at baseline.Operationalized as original except for exhaustion (Hopkins Symptom Checklist), low physical activity (Yales Physical Activity Survey).


6%

Phenotype of frailty(Modified by Woods et al., 2005)

40,657 women aged 65-79 years at baseline.Operationalized as the original except for slowness and weakness (Rand-36 Physical Function scale), exhaustion (4 random questions) and low physical activity (no


16.3%

specific questionnaire).Phenotype of frailty/Rush Memory and Aging project(Modified by Buchman et al., 2011)

949 community dwellers.Operationalized as the original except for weight loss (BMI) and exclusion of physical activity from the assessment.

Continuous rather than categorical measure of physical frailty by converting raw scores from each of the component measures to z-scores using the mean and standard deviation from all participants at baseline. Physical frailty ranged from -1.71 to 1.90 with higher scores indicating greater degree of physical frailty or impairment.


-

Phenotype of frailty/Hispanic Established Populations for the Epidemiologic Studies of the Elderly EPESE(Modified by Graham et al., 2009)

1996 community dwellers Mexican Americans aged 65 years and older.Operationalized as the original except for low physical activity (PASE).


7.8%

Phenotype of frailty/ Frail-CHS (Modified by Rockwood et al., 2006, 2007)

(2007) CSHA wave 2- 728 institutionalized older adults.(2007) CSHA wave 2 – 2305 elderly aged 70 years and older living in the community and in institutions.Operationalized as the original except for exhaustion (feeling tired all the time), low physical activity (needing assistance or not able to walk), slowness (TUG) and weakness (abnormal strength on examination).


-

Biologic syndrome Model/Health and Retirement Study (Cigolle et al., 2009)

11,113 elderly aged 65 years and older living in the community and nursing homes.Operationalized as the original except for weight loss (10% loss or BMI), low physical activity (no specific questionnaire used).


20.3%

Adapted Fried using questionnaire data from RAND-36/SF-36/ Helsinki Businessmen Study (Sirola et al., 2010)

1815 healthy men born 1919-1934.Operationalized as the original except for weight loss (BMI), weakness (one of the questions of the physical function scale of RAND-36), exhaustion (one of the

Robust 0 criteriaPre-frail 1-2 criteriaFrail 3-4 criteria


9.6%

questions of the vitality scale of RAND-36), physical activity (regular physical activity). Slowness was not included.

Gill Frailty Index (Kim et al., 2014; original Gill et al., 2002)

162 males aged 65 years and older enrolled in a geriatric clinic.It consists of 2 criteria and was operationalized in the same way as the original and is thus based solely on physical performance tests: sit-to-stand from chair, walking 10 feet.

0 criteria: not frail1 criterion: moderately frail2 criteria: severely frail

Objective 30.86%

Zutphen Elderly Study(Chin A Paw et al., 1999)

450 men living independently aged 69-89 years.Based on 3 different definitions of frailty items

1. Physical inactivity and low energy intake

2. Physical inactivity and weight loss3. Physical inactivity and low BMI

Frailty:Physical activity <210min/week ANDEnergy intake < 7.6MJ/day OR5 year Weight loss > 4kg ORBMI <23.5kg/m²


1.55 – 6%

Modified Physical Performance Test(Brown et al., 2000; original Reuben DB, Siu AL, 1990)

107 community dwellers aged > 77 years.Consists of 9 physical performance tests including 7 timed standardized tasks plus climbing the stairs and turning 360 °.

Each of the nine items is worth a maximum score of 4 points for a perfect score of 36.>32: not frail25-32: mildly frail17-24: moderately frailty<17: not able to function independently within community

Objective 45% mildly frail, 19% moderately frail

Short Physical Performance Battery (Chang et al., 2013)

234 community dwellers in Taiwan aged 65 years and older.It assesses 3 domains: balance, mobility and flexibility and it involves the following tests: 8-foot up and go test, 30-second chair stand test, back scratch flexibility test and grip.

Right and left hand grip strength and 8-foot up and go test can predict frailtyRight hand grip strength – 17.25kgLeft hand grip strength – 20.75kg8-foot up and go – 8.13s

Objective -

Timed Up and Go TUG(Savva et al., 2013; original Podsiadlo D, Richardosn S., 1991)

1814 community dwellers aged 65 years and older.A test of functional mobility: stand from a seated position, walk 3m at usual pace,

> 10 seconds = frail Objective -

turn around, walk back to chair, and sit down.

FI-SOF (Ensrud et al., 2009; Kiely et al., 2009; Bilotta et al., 2010; Pilotto et al., 2012; original Ensrud et al., 2008)

Ensrud: Osteoporotic fracture in men (MrOS), 3132 community dwelling men aged 67 years and older.Kiely: MOBILIZE Boston Study, 765 community dwellers aged 70 years and older.Bilotta: 302 community dwellers who attended geriatric outpatient clinics.Pilotto: 2033 hospitalized patients aged 65 years and older.Consists of 3 items:Ensrud 2008, 2009; Bilotto 2010: weight loss, inability to rise from a chair 5 times without using arms and poor energy (‘Do you feel full of energy?’/Geriatric Depression Scale).Kiely 2009; Pilotto 2012: operationalized as original except for poor energy (‘Over the past week or so, did you feel like you could not get going?’/CESD-R).

Robust 0 componentsIntermediate 1 componentFrailty ≥ 2 components


Ensrud – 13%Kiely – 4.2%Bilotta – 38%Pilotto – 26.7%

mSOF index (Forti et al., 2012) Conselice Study of Brain Aging, 997 participants aged 65 years and older. Same as original but operationalized in a different way: malnutrition (calf circumference < 31cm), poor mobility (Tinetti score ≤24).

Robust 0 componentsIntermediate 1 componentFrailty ≥ 2 components


11.6%

Table B.1: Frailty instruments linked to the ICF codes

In this table, the individual items of the identified frailty instruments are linked to the ICF – using the 4 th and most detailed category wherever possible. Frailty instrument items corresponding to the ICF component Personal Factors were attributed to this component without using codes. Frailty items corresponding to diseases have been attributed the term health condition (hc).

Frailty instrument/study

International Classification of Functioning, Disability and Health (ICF) Items not covered in the

ICFBody functions Body structures Activities and participation Environmental factors

Personal factors

Capacity Performance70- item Frailty Index/Canadian Study of Health and Aging CSHA (Rockwood et al., 2005, 2006, 2007)

- Poor muscle tone in neck: Chapter 7, Muscle functions, b735, b7350- Bulk difficulties: Chapter 5, Functions related to the digestive system, b525, b5251- Rectal problems: Chapter 5, Functions related to the digestive systems, b525, b5250- Gastrointestinal problems: Chapter 5, Functions related to the digestive system, b515, b520, b525, b535- Sucking problems: Chapter 5, Functions related to the digestive system,

- Head and neck problems: Chapter 7, Structures related to movement, s710- Musculoskeletal problems: Chapter 7- Cardiac problems: Chapter 4, s410, s4100- Lung problems: Chapter 4, s430, s4301- Thyroid problems: Chapter 5, s580, s5801- Skin problems: Chapter 8, s810, s820- Abdominal

- - Impaired mobility: Chapter 4, Walking and moving, d450- Problems getting dressed: Chapter 5, d540, d5400, d5402, d5404- Problems with bathing: Chapter 5, d510, d5101- Problems with carrying out personal grooming: Chapter 5, d520- Toileting problems: Chapter 5, d530, d5300, d5301- Problems cooking: Chapter 6, Household tasks, d630

- - Family history of degenerative disease- Family history relevant to cognitive impairment and loss

- Depression (clinical impression)(hc)- Seizures, partial complex (hc)- Seizures, generalised (hc)-Syncope or blackouts (hc)-History of stroke (hc)-Falls (hc)- Malignant disease (hc)-History of thyroid disease (hc)- History of Parkinson’s disease (hc)-Cerebrovascular problems (hc)-History of diabetes mellitus (hc)

b510, b5100- Poor muscle tone in limbs: Chapter 7, Muscle functions, b735, b7351, b7354- Poor limb coordination: Chapter 7, Movement functions, b760, b7602- Poor coordination, trunk: Chapter 7, Movement functions, b760, b7602- Irregular gait pattern: Chapter 7, Movement functions, b770- Tiredness all the time: Chapter 1, Global mental functions, b130, b1300- Sleep changes: Chapter 1, Global mental functions, b134- Short-term memory impairment: Chapter 1, Global mental functions, b144, b1440- Long-term memory impairment: Chapter 1, Global mental functions, b144, b1441

problems: Chapter 5, s520, s530, s540, s550, s560, s570- Breast problems: chapter 6, s630, s6302

- Problems going out alone: Chapter 4, Walking and moving, d460, d4602- Poor standing posture: Chapter 4, Changing and maintaining body position, d415, d4154

- Other medical history-Changes in everyday activities

- Impaired vibrations: Chapter 2, Additional sensory functions, b270, b2701- Tremor at rest: Chapter 7, Movement functions, b765, b7651- Postural tremor: Chapter 7, Movement functions, b765, b7651- Intention tremor: Chapter 7, Movement functions, b765, b7651- Arterial hypertension: Chapter 4, Functions of the cardiovascular system, b420, b4200- Peripheral pulses: Chapter 4, Functions of the cardiovascular system, b415, b4150- Cardiac problems: Chapter 4, Functions of the cardiovascular system, b410- Myocardial infarction: Chapter 4, Functions of the cardiovascular system, b410, b4103- Arrhythmia: Chapter 4, Functions of the cardiovascular

system, b410, b4100, b4101- Congestive heart failure: Chapter 4, Functions of the cardiovascular system, b410, b4102- Respiratory problems: Chapter 4, Functions of the respiratory system: b440, b445- Thyroid problems: Chapter 5, Functions related to the metabolism and the endocrine system, b555- Skin problems: Chapter 8, Functions of the skin, b810, b820, b830, b840- Memory changes: Chapter 1, Specific mental functions, b144- Changes in general mental functions: Chapter 1, Global mental functions- Onset of cognitive symptoms: Chapter 1, Global mental functions, b117- Bradykinesia, facial: Chapter 1, Specific mental functions,

b147, b1470- Bradykinesia of the limbs: Chapter 1, Specific mental functions, b147, b1470- Mood problems: Chapter 1, Specific mental functions, b152- Feeling sad, blue, depressed: Chapter 1, Specific mental functions, b152-History of depressed mood: Chapter 1, Specific mental functions, b152- Restlessness: Chapter 1, Specific mental functions, b147, b1470- Clouding or delirium: Chapter 1, Global mental functions, b110- Paranoid features: Chapter 1, specific mental functions b160- History relevant to cognitive impairment or loss: Chapter 1, Global mental functions, b117- Headache: Chapter 2, Pain, b280, b2801,

b28010- Urinary incontinence: Chapter 6, Urinary functions, b620, b6202- Presence of snout reflex: Chapter 7, movement functions b750, b7502- Presence of the palmomental reflex: Chapter 7, movement functions, b750, b7502

40- item Frailty Index/CSHA (Rockwood et al., 2006)

- Eyesight problem: Chapter 2, Seeing and related functions, b210- Hearing problem: Chapter 2, Hearing and vestibular functions, b230- History of heart attack: Chapter 4, Functions of the cardiovascular system, b410, b4103- Problems with cough: Chapter 4, Additional functions and sensations of the cardiovascular and respiratory systems, b450- Problems with

- Eye trouble: Chapter 2, s220- Ear trouble, Chapter 2, s240, s250, s260- Dental problem: Chapter 3, s320, s3200, s3201- Stomach problem: Chapter 5, s530- Kidney problem: Chapter 6, s610, s6100- Nerve problem: Chapter 1, s110, s1106; s120, s1201; s140, s150- Skin problem: Chapter 8, s810,

- - Difficulty with eating: Chapter 5, d550- Difficulty with dressing: Chapter 5, d540, d5400, d5402, d5404- Difficulty with taking care of self: Chapter 5, d520- Difficulty with walk around: Chapter 4, Walking and moving, d450, d460- Difficulty with getting in/out bed: Chapter 4, Changing and maintaining body position, d410,

- - Fair or poor self-rated health-Lives alone- Health troubles prevent normal activities

- Problem with feet- Parkinson disease (hc)-Diabetes mellitus (hc)-History of fracture (hc)

sneezing: Chapter 4, Additional functions and sensations of the cardiovascular and respiratory systems, b450- Hypertension: Chapter 4, Functions of the cardiovascular system, b420, b4200- Chest pain: Chapter 4, Functions of the cardiovascular system, b460; Chapter 2, Pain, b280, b2801, b28011- Stomach problem: Chapter 5, Functions related to the digestive system, b510, b5106; b515, b5150, b5151; b535- Kidney problem: Chapter 6, Urinary functions, b610- Urinary incontinent: Chapter 6, Urinary functions, b620, b6202- Bowel incontinent: Chapter 5, Functions related to the digestive system, b525, b5253- Skin problem: Chapter 8, Functions of the skin, b810,

s820- Arthritis: Chapter 7, s770, s7701

d4100- Difficulty with taking shower: Chapter 5, d510, d5101- Difficulty with toileting: Chapter 5, d530, d5300, d5301- Difficulty with using telephone: Chapter 3, Conversation and use of communication devices and techniques, d360, d3600- Difficulty with going out: Chapter 4, Walking and moving, d460, d4602- Difficulty with shopping: Chapter 6, Acquisition of necessities, d620, d6200- Difficulty with preparing meal: Chapter 6, Household tasks, d630- Difficulty with house work: Chapter 6, Household tasks,

b820, b830, b840- Feels tired: Chapter 1, Global mental functions, b130, b1300- Arthritis: Chapter 7, Functions of joints and bones, b710

d640- Difficulty with taking medicine: Chapter 5, d570, d5702-Difficulty with managing money: Chapter 8, Economic life, d860

50-variable Frailty Index derived from Canadian Study of Health and Aging-FICSHA-FI (Joseph et al., 2014)

-Co-morbiditiesHypertension: Chapter 4, Functions of the cardiovascular system, b420, b4200Coagulation problems: Chapter 4, Functions of the hematological and immunological functions, b430, b4303High cholesterol: Chapter 5, Functions related to metabolism and the endocrine function, b540, b5403Kidney problem: Chapter 6, Urinary functions, b610Coronary heart disease: Chapter 4, Functions related to the cardiovascular system, b410, b4103Autoimmune disease: Chapter 4, Functions of the hematological

-Co-morbiditiesKidney problem: Chapter 6, s610, s6100

-Daily activitiesGrooming: Chapter 5, d520Dressing: Chapter 5, d540Getting on/off bed: Chapter 4, Changing and maintaining body position, d420Bathing: Chapter 5, d510, d5101Moving around house: Chapter 4, Walking and moving, d460, d4600Cooking meals: Chapter 6, Household tasks, d630Managing money: Chapter 8, Economic life, d860Driving: Chapter 4, Moving around using transportation,

-FunctionHearing aid: Chapter 1, e125, e1251

- Co-morbiditiesAge >80 yearsSmoking-Health attitudeSelf-rating of health-FunctionLives alone

-Co-morbiditiesStroke (hc)Cirrhosis (hc)COPD (hc)Cancer history (hc)Dementia (hc)Antiplatelet/anti-coagulation medicationImmunosupressor medication-Health attitudeFalls (hc)-FunctionHealth change in past yearSexual active

and immunological systems, b435-Daily activitiesSleep: Chapter 1, Global mental functions b134,Reduced appetite: Chapter 1, Global mental functions, b130, b1302-Health attitudeFeel less useful: Chapter 1, Specific mental functions, b152Feel sad: Chapter 1, Specific mental functions, b152Feel effort to do everything: Chapter 1, Specific mental functions, b152Feel nothing to do: Chapter 1, Specific mental functions, b152Feel lonely: Chapter 1, Specific mental functions, b152Feel anxious: Chapter 1, Specific mental functions, b152Memory loss: Chapter 1, Specific mental functions, b144- Nutrition

d475, d4751Shopping: Chapter 6, Acquisition of necessities, d620, d6200Climbing up/down stairs: Chapter 4, Walking and moving, d455, d4551Doing household work: Chapter 6, Household tasks, d640Toileting: Chapter 5, d530, d5300, d5301Walking: Chapter 4, Walking and moving, d450-FunctionStooping/crouching problem: Chapter 4, Changing and maintaining body position, d410, d4105Regular exercise: Chapter 5, d570, d5701Friends/family: Chapter 7, Particular interpersonal relationships, d750, d760

Hematocrit: Chapter 4, Functions of the hematological and immunological systems, 4301BMI: Chapter 5, Functions related to the digestive system, b530Lost weight > 10 pounds in last year: Chapter 5, Functions related to the digestive system, b530Albumin: Chapter 5, Functions related to the digestive system, b530

Modified Frailty Index mFI (Hodari et al., 2013)

-Respiratory problems: Chapter 4, Functions of the respiratory system, b440, b445-Congestive heart failure: Chapter 4, Functions of the cardiovascular system, b410, b4102-Myocardial infarction: Chapter 4, Functions of the cardiovascular system, b410, b4103- Cardiac problems: Chapter 4, Functions of the cardiovascular

-Lung problems: Chapter 4, s430, s4301-Cardiac problems: Chapter 4, s410, s4100

-Changes in everyday activityProblems getting dressed: Chapter 5, d540, d5400, d5402, d5404 Problems with bathing: Chapter 5, d510, d5101 Problems with carrying out personal grooming: Chapter 5, d520 Problems cooking: Chapter 6, Household tasks, d630

- Family history relevant to cognitive impairment and loss

-History of diabetes mellitus (hc)-Cerebrovascular problems (hc)-History of stroke (hc)

system, b410-Arterial hypertension: Chapter 4, Functions of the cardiovascular system, b420, b4200-Clouding or delirium: Chapter 1, Global mental functions, b110- History relevant to cognitive impairment or loss: Chapter 1, Global mental functions, b117-Decreased peripheral pulses: Chapter 4, Functions of the cardiovascular system, b415, b4150

Problems going out alone: Chapter 4, Walking and moving, d460, d4602

38-item Burden model based on FI in CSHA (Cigolle et al., 2009)

38 items of the Frailty Index in the CHAS including 60 % of measures in each general category (except neurological conditions)

40 item Rockwood Frailty Index RFI (Collerton et al., 2012)

*MMSE: Mini Mental State Examination**GDS: Geriatric Depression Scale

- Ischaemic heart disease: Chapter 4, Functions of the cardiovascular system, b410, b4103- Hypertension: Chapter 4, Functions of the cardiovascular system, b420, b4200- Heart failure:

- Chronic lung disease: Chapter 4, s430, s4301- Chronic joint disease: Chapter 7, s7701- Eye disease: Chapter 2, s220

- - Are you able to get in and out of bed?: Chapter 4, changing and maintaining body position,d410, d4100- Are you able to get in and out of a chair?: Chapter 4,

- - Self-rated health

- Cerebrovascular disease (hc)- Cancer within previous 5 years (hc)- Falls (hc)-Parkinson’s disease (hc)-Diabetes Mellitus (hc)

Chapter 4, Functions of the cardiovascular system, b410, b4102- Chronic joint disease: Chapter 7, Functions of the joints and bones, b710- Visualimpairment: Chapter 2, Seeing and related functions, b210- Hearing impairment: Chapter 2, Hearing and vestibular functions, b230- Peripheral vascular disease: Chapter 4, Functions of the cardiovascular system, b415, b4150- Depressive symptoms (GDS** ≥6):Chapter 1, Specific mental functions, b152- Dizziness: Chapter 2, Hearing and vestibular functions, b240, b2401- Pain: Chapter 2, Pain, b280- Cough: Chapter 4, Additional functions and sensations of the cardiovascular and

changing and maintaining body position, d410, d4103- Are you able to get on and off the toilet?: Chapter 4, changing and maintaining body position, d410, d4103- Are you able to get around in the house? :Chapter 4, walking and moving, d460, d4600- Are you able to walk at least 400 yards?: Chapter 4, walking and moving, d450, d4500- Are you able to dress and undress yourself? :Chapter 5, d540-Are you able to wash your face and hands? :Chapter 5, d510, d5100- Are you able to wash yourself all over? :Chapter 5, d510, d5101

-Osteoporosis (hc)-Thyroid disease (hc)- Dementia (hc)- Oedema feet/ankle/leg

respiratory systems, b450- Difficulty swallowing: Chapter 5, Functions related to the digestive system: b510, b5105- Cognitive function (MMSE* ≤ 25): Chapter 1, Global mental functions: b117 - Clinically significant arrhythmia: Chapter 4, Functions of the cardiovascular system, b410, b4100, b4101-Urinary incontinence: Chapter 6, Urinary functions, b620, b6202-Faecal incontinence: Chapter 5, Functions related to the digestive system, b525, b5253

- Are you able to cut your own toenails?: Chapter 5,d520, d5204- Are you able to feedyourself?: Chapter 5, d550- Are you able to take your medication? :Chapter 5, d570, d5702-Are you able to manage money such as paying bills and keeping track of expenses?: Chapter 8, Economic life, d 860

51 variables / Gothenburg H-70 study (Rockwood, Mitnitski et al., 2006; original Steen BH, Djurfeldt H, 1993)

- Feels tired: Chapter 1, Global mental functions, b130, b1300- Angina pectoris: Chapter 4, Functions related to the cardiovascular system: b410, b4103,

- Knee/joint problem: Chapter 7, s750, s7501, s75011- Prostate problems: Chapter 6, s6306- Positive F-HB (>0): Chapter 5,

- Difficulty with take care of self: Chapter 5, Self-care- Difficulty with taking care of house: Chapter 6, Household tasks, d640, Caring for household objects

- No family member available to care: Chapter 3, e310, e315

- Feels health is not good- Feels lonely-Lives alone

- Problem with being disturbed?- Sedimentation rate >35/30 F/M- T-wave abnormality-Thyroid disease (hc)-Pulmonary

b460- Low HB (<120/130 F/M): Chapter 4, Functions of the haematological and immunological systems, b430, b4300, b4301- High Creatinine (>150): Chapter 6, Urinary functions, b610, b6100- High glucose (highest quartile) >102: Chapter 5, Functions related to metabolism and the endocrine system, b540, b5401- High cholesterol (highest quartile) >6.84: Chapter 5, Functions related to metabolism and the endocrine function, b540, b5403- Low appetite:Chapter 1, Global mental functions, b130, b1302- Stool problem:Chapter 5, Functions related to the digestive system, b525, b5250, b5251, b5252, b5253- Chest pain: Chapter

s520, s530, s540- Low Fe/TIBC (x100 <16): Chapter 5, s520, s530, s540- Arthritis: Chapter 7, s770, s7701

and assisting others, d650, d6501, d6502, d6505- No contact with children: Chapter 7, Particular interpersonal interactions, d760, d7600- No relatives or friends: Chapter 7, Particular interpersonal interactions, d750, d7500; d760- Does not travel: Chapter 9, d920- Not a member of any retirement group: Chapter 9, d910, d9100- Has no contact with others: Chapter 7, General interpersonal interactions, d710, d720- Needs to use aid to walk: Chapter 4, Walking and moving, d450, d465

oedema (hc)-Diabetes (hc)- Cancer (hc)- Asthma (hc)- Pulmonary effusion (hc)

2, Pain, b280, b2801, b28011; Chapter 4, functions related to the cardiovascular system, b460- Can only chew soft food:Chapter 5, Functions related to the digestive system, b510, b5102- Dyspnea: Chapter 4, Functions of the respiratory system, b460- Wrist pain: Chapter 2, Pain, b280, b2801, b28014- Respiratory problems: Chapter 4, Functions of the respiratory system, b440, b445- Tremor: Chapter 7, Movement functions, b765, b7651- Rigidity: Chapter 7, Muscle functions, b735- Absent ankle reflex: Chapter 7, Movement functions, b750, b7500- Hearing problem: Chapter 2, Hearing and vestibular functions, b230

- ST segment depression: Chapter 4, Functions of the cardiovascular system, b410, b4103- Sinus tachycardia:Chapter 4, Functions of the cardiovascular system, b410, b4100- Hypertension: Chapter 4, Functions of the cardiovascular system, b420, b4200- Myocardial infarction: Chapter 4, Functions of the cardiovascular system, b410, b4103- Diastolic blood pressure > 90mmHg: Chapter 4, Functions of the cardiovascular system, b420, b4200- BMI < 20: Chapter 5, Functions related to the digestive system, b530- BMI >30: Chapter 5, Functions related to the digestive system, b530- Peak flow meter reading: Chapter 4, Functions of the respiratory system, b440, b445- Arthritis: Chapter 7,

Functions of the joints and bones, b710

Modified 43 items Armstrong Index (Hogan et al., 2012; original Armstrong et al., 2010)

- Persistent anger: Chapter 1, Specific mental functions, b152- Withdrawal from activities of interest: Chapter 1, Global mental functions, b130, b1301- Renal disease: Chapter 6, Urinary functions, b610- Coronary heart disease: Chapter 4, Functions related to the cardiovascular system, b410, b4103- Peripheral vascular disease: Chapter 4, Functions of the cardiovascular system, b415, b4150- Moderate/severe hearing problems: Chapter 2, Hearing and vestibular functions, b230- Moderate/severe vision problems: Chapter 2, Seeing and related functions, b210- Bladder incontinence: Chapter 6, Urinary

- Renal disease: Chapter 6, s610, s6100- Arthritis: Chapter 7, s770, s7701

- Sad, pained, worried facial expressions: Chapter 3, Communicating – producing, d335, d3350- Reduced social interactions: Chapter 7, General interpersonal interactions, d710, d720- Help with meal preparation: Chapter 6, Household tasks, d630- Help with ordinary housework: Chapter 6, Household tasks, d640- Help with managing finances: Chapter 8, Economic life, d860- Help with managing medications: Chapter 5, d570, d5702- Help with stair climbing: Chapter

- Poor self-reported health- Unstable health- Repetitive health complaints

-Stroke or CVA (hc)- Thyroid disease (hc)-Parkinson’s disease (hc)- Diabetes (hc)-Multiple sclerosis (hc)- COPD/Emphysema Asthma / (hc)- Unrealistic fears (hc)- Alzheimer’s disease/dementia (hc)- Hip fracture, other fractures, osteoporosis (hc)

functions, b620, b6202- Hemiplegia: Chapter 7, Muscle functions, b730, b7302; b735, b7352- Hypertension: Chapter 4, Functions of the cardiovascular system, b420, b4200- Congestive heart failure: Chapter 4, Functions of the cardiovascular system, b410, b4102- Balance, Unsteady gait: Chapter 2, Hearing and vestibular functions, b235, b2351- BMI 30-40, BMI >40: Chapter 5, Functions related to the digestive system, b530- Weight loss 5% or more in last 30 days or 10% in last 180 days: Chapter 5, Functions related to the digestive system, b530- Cardiac arrhythmias: Chapter 4, Functions of the cardiovascular system, b410, b4100,

4, Walking and moving, d455, d4551- Help with shopping: Chapter 6, Acquisition of necessities, d620, d6200- Help with bathing: Chapter 5, d510, d5101- Help with personal hygiene: Chapter 5, d510, d520- Help with dressing upper body: Chapter 5, d540, d5400, d5404- Help with dressing lower body: Chapter 5, d540, d5400, d5402, d5404- Help with locomotion: Chapter 4, Walking and moving, d450; d455; d465- Help with transferring: Chapter 4, Changing and maintaining body position, d420- Help with toilet

b4101- Arthritis: Chapter 7, Functions of the joints and bones, b710

use: Chapter 5, d530, d5300, d5301- Help with eating: Chapter 5, d550

83 items Full Frailty Index (Hogan et al., 2012)

- Persistent anger: Chapter 1, Specific mental functions, b152- Repetitive anxiety: Chapter 1, specific mental functions, b152- Coronary heart disease: Chapter 4, Functions related to the cardiovascular system, b410, b4103- Renal disease: Chapter 6, Urinary functions, b610- Crying, tearfulness: Chapter 1, Global mental functions, b126, b1263- Lack of pleasure in life: Chapter 1, Global mental functions, b126, b1265- Withdrawal from activities of interest: Chapter 1, Global mental functions, b130, b1301- Short-term memory problems: Chapter 1, Global mental

- Renal disease: Chapter 6, s610, s6100- Arthritis: Chapter 7, s770, s7701

- - Not close to someone in facility: Chapter 7, Particular interpersonal relationships, d750, d7503-Help with phone use: Chapter 3,Conversation and use of communication devices and techniques, d360, d3600- Help with stair climbing: Chapter 4, Walking and moving, d455, d4551- Help with shopping: Chapter 6, Acquisition of necessities, d620, d6200- Help with bathing: Chapter 5, d510, d5101- Help with personal hygiene: Chapter 5, d510, d520

- No strong supportive relationship with family: Chapter 3, e310, e315

- Poor self-reported health- Repetitive health complaints

- Cancer (hc)-Stroke or CVA (hc)-At least 1 fall in the last 30 days (hc)- Multiple sclerosis (hc)- Parkinson’s disease (hc)- Diabetes (hc)-Asthma/Emphysema/COPD (hc)- Unrealistic fears (hc)- Alzheimer’s disease/dementia (hc)- Hip fracture, other fractures, osteoporosis (hc)-10 or more medications-Peripheral edema

functions, b144, b1440- Procedural memory problems: Chapter 1, Global mental functions, b144, b1441- Situational memory problems: Chapter 1, Global mental functions, b144- Easily distracted: Chapter 1, Global mental functions, b140, b1400- Episodes of disorganized speech: Chapter 1, Specific mental functions, b167, b1672- Moderate/severe hearing problems: Chapter 2, Hearing and vestibular functions, b230- Moderate/severe vision problems: Chapter 2, Seeing and related functions, b210- Hemiplegia: Chapter 7, Muscle functions, b730, b7302; b735, b7352- Paraplegia/ quadriplegia: Chapter 7, Muscle functions,

- Help with dressing upper body: Chapter 5, d540, d5400, d5404- Help with dressing lower body: Chapter 5, d540, d5400, d5402, d5404-Help with walking: Chapter 4, Walking and moving, d450, d465- Help with locomotion: Chapter 4, Walking and moving, d450, d455, d465- Help with transferring: Chapter 4, Changing and maintaining body position, d420- Help with toilet use: Chapter 5, d530, d5300, d5301-Help with bed mobility: Chapter 4, Changing and maintaining body position, d410, d4106-Help with eating: Chapter 5, d550

b730, b7303, b7304; b735, b7353, b7354- Hypertension: Chapter 4, Functions of the cardiovascular system, b420, b4200- Peripheral vascular disease: Chapter 4, Functions of the cardiovascular system, b415, b4150- Congestive heart failure: Chapter 4, Functions of the cardiovascular system, b410, b4102- Balance – turning around: Chapter 2, Hearing and vestibular functions, b235, b2351- Balance – dizziness: Chapter 2, Hearing and vestibular functions, b240, b2401- Balance – Unsteady gait: Chapter 2, Hearing and vestibular functions, b235, b2351- Chest pain: Chapter 2, Pain, b280, b2801, b28011; Chapter 4, Functions of the cardiovascular system, b460

- Declined in ADL over last 90 daysBathing: Chapter 5, d510, d5101Dressing: Chapter 5, d540, d5400, d5402, d5404Toileting: Chapter 5, d530, d5300, d5301Transferring: Chapter 4, Changing and maintaining body position, d420Feeding: Chapter 5, d550- Declined decision-making last 90 days: Chapter 1, Applying knowledge, d177- Infrequent participation in longstanding social activities: Chapter 9, d920, d9205- Infrequent interaction with friends/family: Chapter 7, d750, d7500; d760- Reduced social interactions: Chapter 7, General interpersonal interactions, d710,

- Abnormal thought process: Chapter 1, Specific mental functions, b160- Delusions: Chapter 1, Specific mental functions, b160, b1602- Hallucinations: Chapter 1, Specific mental functions, b156- Makes negative statements: Chapter 1, Global mental functions, b126, b1265- Aphasia: Chapter 1, Specific mental functions, b167, b1670, b16700, b16701; b1671, b16710, b16711- Vomiting: Chapter 5, Functions related to the digestive system, b510, b5106- Non-restful sleep/insomnia: Chapter 1, Global mental functions, b134- Too much sleep: Chapter 1, Global mental functions, b134, b1340- Shortness of breath:

d720- Sad, pained, worried facial expressions: Chapter 3, Communicating-producing, d335, d3350- Minimally impaired or moderately/severely impaired decision-making skills: Chapter 1, Applying knowledge, d177- At least some difficulty to make self understood: Chapter 3, Communicating-producing, d330, d335, d340, d345- At least some difficulty understanding: Chapter 3, Communicating-receiving, d310, d315, d320, d325- Less than 1 hour of physical activity in last 3 days: Chapter 5, d570, d5701- Fatigue – cannot complete day-to-

Chapter 4, Additional functions and sensations of the cardiovascular and respiratory systems, b460- Fatigue - cannot complete day-to-day activities: Chapter 4, Additional functions and sensations of the cardiovascular and respiratory systems, b455, b4552- Pain present: Chapter 2, Pain, b280- BMI 30-40, BMI >40: Chapter 5, Functions related to the digestive system, b530- Weight loss 5% or more in last 30 days or 10% in last 180 days: Chapter 5, Functions related to the digestive system, b530- Allergy to any drug: Chapter 4, Functions of the haematological and immunological systems, b435, b4351- Cardiac arrhythmias: Chapter 4, Functions of the cardiovascular

day activities: Chapter 2, d230, d2303

system, b410, b4100, b4101- Incontinence: Chapter 5, Functions related to the digestive system, b525, b5253; Chapter 6, Urinary functions, b620, b6202- Arthritis: Chapter 7, Function s of the joints and bones, b710

48 items Deficits index DI (Kulminski et al., 2008)

- Nervous and emotional disorders: Chapter 1, Specific mental functions, b152- High blood pressure: Chapter 4 , Functions of the cardiovascular system, b420, b4200- Hearing problems: Chapter 2, hearing and vestibular functions, b230- Vision Problems: Chapter 2, Seeing and related functions, b210- Pulmonary diseases: Chapter 4, Functions of the respiratory system, b440, b445- Heart disease: Chapter 4, functions

- Pulmonary diseases: Chapter 4, Structures of the respiratory system, s430, s4301- Heart disease: Chapter 4, s410, s4100- Arthritis: Chapter 7, s770, s7701

- - Difficulty walking: Chapter 4, walking and moving, d450- Trouble walking half a mile: Chapter 4, walking and moving, d450, d4500- Trouble walking 10 steps: Chapter 4, walking and moving, d450, d4500- Walking for exercise: Chapter 4, walking and moving, d450; Chapter 5, d570, d5701- Exercise- cycle: Chapter 4, Moving around using transportation, d475, d4750;

- Having people to talk to when lonely: Chapter 3, e310, e315, e320, e325, e335, e340, e355

- Feeling about life- Life satisfaction- Groggy

- Calisthenic exercises- Major electrocardiogram abnormality- Swelling of feet or ankles-Diabetes mellitus (hc)-Pneumonia (hc)-Pulmonary embolus (hc)- Cancer (hc)-Asthma (hc)

of the cardiovascular system, b410- Sleep on two or more pillows to help breathe: Chapter 4, additional functions and sensations of the cardiovascular and respiratory systems, b460- Awakened by troubled breathing: Chapter 4, additional functions and sensations of the cardiovascular and respiratory systems, b460; Chapter 1, Global mental functions, b134, b1342- Pain in legs on walking: Chapter 4, Functions of the cardiovascular system, b415, b4150- Cough: chapter 4, additional functions and sensations of the cardiovascular and respiratory systems, b450- Short of breath: Chapter 4, functions of the respiratory system, b460- Palpitations:

Chapter 5, d570, d5701- Dancing: Chapter 9, d920- Household chores: Chapter 6, Household tasks, d640- Mowing lawn: Chapter 6, caring for household objects and assisting others, d650, d6505- Raking lawn: Chapter 6, caring for household objects and assisting others, d650, d6505- Gardening: Chapter 6, caring for household objects and assisting others, d650, d6505- Difficulties lifting: Chapter 4, carrying, moving and handling objects, d430, d4300- Reaching out: Chapter 4, carrying, moving and handling objects, d445, d4452- Gripping: Chapter

Chapter 4, additional functions and sensations of the cardiovascular and respiratory systems, b460- Dizziness: Chapter 2, hearing and vestibular functions, b240, b2401- Fatigue: Chapter 4, additional functions and sensations of the cardiovascular and respiratory systems, b455, b4552- Weakness: Chapter 7, muscle functions, b730- Nausea: Chapter 5, functions related to the digestive system, b535, b5350- Indigestion: Chapter 5, Functions related to the digestive system, b535- Diarrhea: Chapter 5, functions related to the digestive system, b525, b5251- Trouble falling asleep: Chapter 1, global mental functions, b134, b1341- Orthostatic

4, Carrying, handling and moving objects, b440, b4401- Difficulties standing up without using the arms: Chapter 4, changing and maintaining body position, d410, d4104

hypotension: Chapter 4, functions of the cardiovascular system, b420, b4201- Bleeding: Chapter 4, Functions of the haematological and immunological systems, b430, b4303- Arthritis: Chapter 7, Functions of the joints and bones, b710

32 items Frailty Index – Cumulative Deficits FI-CD (Pilotto et al., 2012; original Ensrud et al., 2009)

- History of heart attack: Chapter 4, Functions related to the cardiovascular system, b410, b4103- Stomach problems: Chapter 5, Functions related to the digestive system, b510, b5106; b515, b5150, b5151, b535-Hypertension: Chapter 4, Functions of the cardiovascular system, b420, b4200- Trouble with bladder/bowels: Chapter 5, Functions related to the digestive system, b515, d5150; b525, b5253; Chapter 6, Urinary functions, b610, b620- Problems with

- Broken hip: Chapter 7, s750, s7500, s75000- Broken bones: Chapter 7, s770, s7700- Stomach problems: Chapter 5, s530- Ear problems: Chapter 2, s240, s250, s260- Problems with teeth: Chapter 3, s320, s3200- Problems with feet: Chapter 7, s750, s7502-Arthritis: Chapter 7, s770, s7701

- Difficulty with eating: Chapter 5, d550- Difficulty with dressing: Chapter 5, d540, d5400, d5402, d5404- Difficulty with walk around: Chapter 4, Walking and moving, d450- Difficulty with getting in/out bed: Chapter 4, Changing and maintaining body position, d410, d4100- Difficulty with getting a bath: Chapter 5, d510, d5101- Difficulty with toileting: Chapter 5, d530, d5300,

- Self-rated health

- Flu (hc)-History of stroke (hc)-Parkinson’s disease (hc)- Glaucoma (hc)- Diabetes (hc)-Dementia (hc)

vision: Chapter 2, Seeing and related functions, b210- Problems with hearing: Chapter 2, Hearing and vestibular functions, b230-Arthritis: Chapter 7, Functions of the joints and bones, b710

d5301- Difficulty with using telephone: Chapter 3, Conversation and use of communication devices and techniques, d360, d3600- Difficulty with going out: Chapter 4, Walking and moving, d460, d4602- Difficulty with shopping: Chapter 6, Acquisition of necessities, d620, d6200- Difficulty with cooking: Chapter 6, Household tasks, d630- Difficulty with light house work: Chapter 6, Household tasks, d640- Difficulty with taking medicine: Chapter 5, Self-care, d570, d5702-Difficulty with managing money: Chapter 8, Economic life, d860

62 items Frailty Index (Woo et al., 2006)

- Difficulties with hearing: Chapter 2, hearing and vestibular functions, b230- Difficulties with vision: Chapter 2, Seeing and related functions, b210- Difficulties with chewing: chapter 5, functions related to the digestive system, b510, b5102- Mental score < 7: Chapter 1, Global mental functions, b117- Weight loss ≥ 5lbs in past year: Chapter 5, functions related to the digestive system, b530- PMH:Cardiac diseases: Chapter 4, functions of the cardiovascular system, b410Hypertension: Chapter 4, functions of the cardiovascular system, b420, b4200- Cough blood in the past month: Chapter 4, Additional functions and sensations of the cardiovascular and

- PMH:Cardiac diseases: Chapter 4, s410, s4100Peptic ulcer: Chapter 5, s530, s540Arthritis: Chapter 7, s770, s7701

- - Cannot walk for 1 mile: chapter 4, walking and moving, d450, d4501- Cannot walk for 100 yards: chapter 4, walking and moving, d450, d4500- Dependent in feeding: chapter 5, d550- Dependent in personal grooming: chapter 5, d520- Dependent in chair/bed shifting: chapter 4, changing and maintain body position, d420, d4200- Dependent in walking: chapter 4, walking and moving, d465- Dependent in walking up/down the stairs: chapter 4, walking and moving, d455, d4551, d465- Dependent in using toilet: Chapter 5, d530, d5300, d5301

- Doctor consultation in the past year 3+ times: Chapter 5, e580, e5800- Hospital admission in the past year 2+ times: Chapter 5, e580, e5800

- Self perceived physical health not quite good/poor

-Swelling in leg in the past month- Number of drugs used 1-4 or > 5- Falls in the past year 1-2 times (hc)- Falls in the past year >3 times (hc)- PMH:Cerebrovascular disease (hc)Parkinson’s disease (hc)Chronic bronchitis (hc)Asthma (hc)TB (hc)Diabetes mellitus (hc)Dementia (hc)Psychiatric problems (hc)Malignancy (hc)Old fracture (hc)Other diseases (hc)

respiratory system, b450- Cough up phlegm for 3 consecutive months for 2 years: Chapter 4, Additional functions and sensations of the cardiovascular and respiratory system, b450- Bring up phlegm in the morning: Chapter 4, Additional functions and sensations of the cardiovascular and respiratory system, b450- Headache in the past month: Chapter 2, Pain, b280, b2801, b28010- Woken up with a feeling of tightness in the chest in the past year: Chapter 1, Global mental functions, b134, b1342; Chapter 4, Additional functions and sensations of the cardiovascular and respiratory system: b460- Breathless when not doing anything

- Dependent in bathing: chapter 5, d510, d5101- Need a walking aid usually: chapter 4, walking and moving, d465

stern: Chapter 4, Additional functions and sensations of the cardiovascular and respiratory system, b460- Woken at night by attack of breathlessness: Chapter 1, Global mental functions, b134, b1342; Chapter 4, Additional functions and sensations of the cardiovascular and respiratory system: b460-Dizziness in the past month: Chapter 2, hearing and vestibular functions, b240, b2401- Heart palpitation in the past month: Chapter 4, additional functions and sensations of the cardiovascular and respiratory systems, b460- Worsening of memory in the past month: chapter 1, specific mental functions, b144- Constipation in the

past month: Chapter 5, functions related to the digestive system, b525, b5251, b5252- Stomach pain in the past month: chapter 2, pain, b280, b28012- Joint pain: chapter2, pain, b280, b28016- Chest pain while walking uphill or briskly: Chapter 4, Functions of the cardiovascular system, b410, b4103; b460 (Walking: Activities and Participation: d450)- Chest pain while walking on level ground: Chapter 4, Functions of the cardiovascular system, b410, b4103; b460 (Walking: Activities and Participation: d450)- Feeling breathlessness while lying flat in bed: Chapter 4, additional functions and sensations of the cardiovascular and respiratory systems, b460 (lying flat: Activities and

Participation: d4150)- Wheezing or whistling in chest in past year: Chapter 4, additional functions and sensations of the cardiovascular and respiratory systems, b460- Urinary incontinence: Chapter 6, Urinary functions, b620, b6202- Bowel incontinence: Chapter 5, Functions related to the digestive system, b525, b5253- Systolic blood pressure > 140mmHg: Chapter 4, Functions of the cardiovascular system, b420, b4200- Diastolic blood pressure > 90mmHg: Chapter 4, Functions of the cardiovascular system, b420, b4200- Body mass index < 18.5kg/m2: Chapter 5, functions related to the digestive system, b530- Walking unsteady or stagger: Chapter 7,

movement functions, b770- Geriatric depression score >8: Chapter 1, Specific mental functions, b152- Arthritis: Chapter 7, Functions of the joints and bones, b710

47 items Frailty Index FI(Woo et al., 2012)

*CSID: Cognitive screening instrument for dementia

**GDS: Geriatric Depression Scale

***PASE: Physical Activity Scale for the Elderly

- Presence of back pain limiting activities: Chapter 2, Pain, b280, b2801, b28013- Cognitive impairment using CSID*/cut-off 28.4: Chapter 1, Global mental functions, b117- Weight: Chapter 5, Functions related to the digestive system, b530- Blood pressure: Chapter 4, Functions of the cardiovascular system, b420- Ankle brachial index: Chapter 4, Functions of the cardiovascular system, b415, b4150- Clumsiness in walking: Chapter 7, Movement functions, b770

- Grip strength: Chapter 4, Carrying, moving and handling objects, d440, d4401

- Clumsiness using hands: Chapter 4, Carrying, moving and handling objects, d440, d445- Difficulty performing activities of daily livingWalking 2-3 blocks outside on level ground: Chapter 4, Walking and moving, d460, d4602Climbing 10 steps without resting: Chapter 4, Walking and moving, d455, d4551Preparing own meals: Chapter 6, Household tasks, d630 Doing heavy housework: Chapter 6, Household tasks, d640

- Self-reported health- Height

- History of falls in the past 12 months (hc)-History of osteoporotic fractures (hc)

- Number of prescription medications- Presence or absence of disease (hc)

- Depressive symptoms using GDS** ≥ 8: Chapter 1, Specific mental functions, b152

Shopping for groceries or clothes: Chapter 6, d620, d6200- Physical activity using PASE***: Chapter 5, d570, d5701- Time and number of steps to walk 6m: Chapter 4, Walking and moving, d450, d4500

44 items Deficit Accumulation Index DAI (Hastings et al., 2008)

- Myocardial infarction: Chapter 4, Functions of the cardiovascular system, b410, b4103- Angina pectoris: Chapter 4, Functions related to the cardiovascular system: b410, b4103, b460- Other heart conditions: Chapter 4, functions of the cardiovascular system, b410, b4100, b4101, b4102- Hypertension: Chapter 4, Functions of the cardiovascular system, b420, b4200- Hearing difficulty: Chapter 2, Hearing

- Other heart conditions: Chapter 4, s410, s4100- Broken hip: Chapter 7, s750, s7500, s75000- Hardening of the arteries: Chapter 4, s410, s4101- Arthritis: Chapter 7, s770, s7701

- Difficulty stooping or kneeling: Chapter 4, Changing and maintaining body position, d410, d4102, d4105- Difficulty walking: Chapter 4, walking and moving, d450- Difficulty lifting 10lbs: Chapter 4, Carrying, moving and handling objects, d430, d4300- Difficulty doing heavy housework: Chapter 6, Household tasks, d640- Difficulty shopping: Chapter

- Fair or poor self-rated health- Health limited social life past month

- Cataracts (hc)- Diabetes mellitus (hc- Non-skin cancer (hc)- Skin cancer (hc)-Emphysema, asthma, or chronic obstructive pulmonary disease (hc)-Stroke or brain haemorrhage (hc) -Rheumatoid arthritis (hc)-Mental disorder (hc)- Alzheimer’s disease (hc)-Osteoporosis (hc)

and vestibular functions, b230- Vision difficulty: Chapter 2, Seeing and related functions, b210- Lost urine last 12 months: chapter 6, urinary functions, b620, b6202- Trouble concentrating: Chapter 1, Specific mental functions, b140, b1400- Memory loss interferes with activity: Chapter 1, Specific mental functions, b144- Partial paralysis: Chapter 7, Muscle functions, b730- Difficulty eating solid foods: Chapter 5, Functions related to the digestive system, b510, b5101, b5102, b5103, b5105- Difficulty reaching over head: Chapter 7, Functions of the joints and bones, b710- Arthritis: Chapter 7, Functions of the joints and bones, b710

6, Acquisition of necessities, d620, d6200- Difficulty doing light housework: Chapter 6, Household tasks, d640- Difficulty writing: Chapter 1, Applying knowledge, d170- Difficulty getting into or out of a chair: Chapter 4, changing and maintaining body position, d410, d4103- Difficulty bathing: Chapter 5, d510, d5101- Difficulty making meals: Chapter 6, Household tasks, d630- Difficulty eating: Chapter 5, d550- Difficulty managing money: Chapter 8, Economic life, d860- Difficulty dressing: Chapter 5, d540, d5400, d5402, d5404- Difficulty using the phone: Chapter

3, Conversation and use of communication devices and techniques, d360, d3600- Difficulty using the toilet: Chapter 5, d530, d5300, d5301- Problem making decisions: Chapter 1, Applying knowledge, d177

43 items Frailty Index/ Conselice Study of Brain Aging (Lucicesare et al., 2010; original Jones et al., 2004)

Health deficits which are not specified

CSHA rules-based definition of frailtybased on GSS/ Composite B/ Deficit Accumulation Index DAI derived from CGA (Purser et al, 2006; Salvi et al., 2012; original Rockwood et al., 1999)

*bADL: basic activities of daily living

- Urinary incontinence: Chapter 6, Urinary functions, b620, b6202- Bowel incontinence: Chapter 5, Functions related to the digestive system, b525, b5253- Cognitive impairment: Chapter 1, Global mental functions b117

- Walking: Chapter 4, Walking and moving, d450- bADL*Bathing: Chapter 5, d510, d5101Dressing: Chapter 5, d540, d5400, d5402, d5404Transferring: Chapter 4, Changing and maintaining body position, d420 Eating: Chapter 5, d550

Canadian Study of - Energetic and - Active/fit/ - Active

health and Aging Clinical Frailty Scale CSHA – CFS(Rockwood et al., 2005, 2007)

*bADL: basic activities of daily living**IADL:instrumental activities of daily living

motivated: Chapter 1, Global mental functions, b130, b1300, b1301- Slowed up: Chapter 1, Global mental functions, b130, b1300

exercise regularly: Chapter 5, d570, d5701-bADL*:Bathing: Chapter 5, d510, d5101Dressing: Chapter 5, d540, d5400, d5402, d5404Toileting: Chapter 5, d530, d5300, d5301Transferring: Chapter 4, Changing and maintaining body position, d420Feeding: Chapter 5, d550-IADL**Ability to use telephone: Chapter 3, Conversation and use of communication devices and techniques, d360, d3600Shopping: Chapter 6, Acquisition of necessities, d620, d6200Food preparation: Chapter 6, Household tasks, d630Housekeeping:

diseases/disease symptoms (hc)-Terminally ill-Robust

Chapter 6, Household tasks, d640 Laundry: Chapter 6, Household tasks, d640, d6400Mode of transportation: Chapter 4, Moving around using transportation, d470, d475,Responsibility for own medications: Chapter 5, d570, d5702 Ability to handle finances: Chapter 8, Economic life, d860

Chinese-Canadian Study of Health andAging Clinical Frailty Scale Telephone Version CSHA-CFS TV(Chan et al., 2010)

- Did you feel slowed down recently? : Chapter 1, Global mental functions, b130, b1300

-Assistance in 5 basic ADLs:Bathing: Chapter 5, d510, d5101Dressing: Chapter 5, d540, d5400, d5402, d5404Eating: Chapter 5, d550Toileting: Chapter 5, d530, d5300, d5301Transferring: Chapter 4, Changing and maintaining body position, d420-Assistance in 8

- Do you think that you are fittercompared to someone of your age?

- Do you have any chronic diseases that require treatment? (hc)- Are the symptoms from the chronic diseases well or poorly controlled?

instrumental ADLs:Using telephone: Chapter 3, Conversation and use of communication devices and techniques, d360, d3600Shopping: Chapter 6, Acquisition of necessities, d620, d6200Preparing food: Chapter 6, Household tasks, d630Housekeeping: Chapter 6, Household tasks, d640Transportation: Chapter 4, Moving around using transportation, d470, d475Laundry: Chapter 6, Household tasks, d640, d6400Taking medicine: Chapter 5, d570, d5702Financing: Chapter 8, Economic life, d860

Frailty Index Comprehensive

- Cognitive status: Chapter 1, Global

- Mobility (TUG*): Chapter 4,

- Social (institutionalized,

-Co-morbidities (CIRS*****)

Geriatric Assessment FI CGA (Pilotto et al., 2012; original Jones et al., 2004)

*TUG: timed up and go** GDS: geriatric depression scale***bADL: basic activities of daily living****IADL: instrumental activiteis of daily living*****CIRS: cumulative illness rating scale

mental functions, b117- Mood and motivation (GDS**): Chapter 1, Global mental function, b152- Communication (vision, hearing, speech): Chapter 2, Seeing and related functions, b210; Chapter 2, Hearing and vestibular functions, b230; Chapter 3, Voice and speech functions, b310, b320, b330-Balance(Functional reach): Chapter 4, Carrying, moving and handling objects, d445, d4452- Bowel function: Chapter 5, Functions related to the digestive system, b515, b525- Bladder function: Chapter 6, Urinary functions, b620- Nutrition (stable weight/weight change): Chapter 5, Functions related to the digestive system, b530

Changing and maintaining body position, d410, d4103; Walking and moving, d450, d4500- bADL***Bathing: Chapter 5, d510, d5101Dressing: Chapter 5, d540, d5400, d5402, d5404Toileting: Chapter 5, d530, d5300, d5301Transferring: Chapter 4, Changing and maintaining body position, d420Feeding: Chapter 5, d550- IADL****Ability to use telephone: Chapter 3, Conversation and use of communication devices and techniques, d360, d3600 Shopping: Chapter 6, Acquisition of necessities, d620, d6200Food preparation: Chapter 6,

uses formal home supports, lives alone)

-BalanceFalls - hc

Household tasks, d630Housekeeping: Chapter 6, Household tasks, d640Laundry: Chapter 6, Household tasks, d640, d6400Mode of transportation: Chapter 4, Moving around using transportation, d470, d475,Responsibility for own medications: Chapter 5, d570, d5702Ability to handle finances: Chapter 8, Economic life, d860

Multidimensional Prognostic Index MPI based on CGA (Pilotto et al., 2012; original Pilotto et al., 2008)

*SPMSQ: Short Portable Mental Status Questionnaire**ESS: Exton-Smith Scale***ADL: activities of daily living****IADL: instrumental activities of daily living*****C.I.R.S.: Cumulative

- ADL***; ESS**Continence Chapter 5, Functions related to the digestive system, b525, b5253; Chapter 6, urinary functions, b620, b6202- Cognitive (SPMSQ*): Chapter 1, Global mental functions, b117- Risk of developing pressure sores

- - ADL***Bathing: Chapter 5, d510, d5101Dressing: Chapter 5, d540, d5400, d5402, d5404Toileting: Chapter 5, d530, d5300, d5301Transferring: Chapter 4, Changing and maintaining body position, d410,

- - Co-habitation status (alone, with relatives, in institution)- ESS**General condition

- Number of drugs used- C.I.R.S.***** (hc)

illness rating scale******MNA: Mini Nutritional Assessment

(ESS**)Mental state: Chapter 1, Global mental functions, b110, b1100

d4100, d4103Feeding: Chapter 5, d550-IADL****Ability to use telephone: Chapter 3, Conversation and use of communication devices and techniques, d360, d3600Shopping: Chapter 6, Acquisition of necessities, d620, d6200Food preparation: Chapter 6, Household tasks, d630 Housekeeping: Chapter 6, Household tasks, d640 Laundry: Chapter 6, Household tasks, d640, d6400Mode of transportation: Chapter 4, Moving around using transportation, d470, d475Responsibility for own medications: Chapter 5, d570, d5702

Ability to handle finances: Chapter 8, Economic life, d860- ESS**Mobility in bed: Chapter 4, Changing and maintaining body position, d420, d4201Activity: Chapter 4, Walking and moving, d450, d465-Nutrition (MNA******): Chapter 5, d570, d5701

Adjusted Clinical Groups-diagnoses based computerized predictive model frailty tag ACG frail/outpatient CGA study at Israeli Health Maintenance Organisation (Sternberg et al., 2012)

- Impaired vision: Chapter 2, Seeing and related functions, b210- Decubitus ulcer: chapter 8, Functions of the skin, b810- Incontinence of urine or faeces: Chapter 5, Functions related to the digestive system, b525, b5253; Chapter 6, urinary functions, b620, b6202- Loss of weight: chapter 5, functions related to the

- Difficulty walking: Chapter 4, d450- Malnutrition: Chapter 5, d570, d5701

-Barriers to access of care: Chapter 5, e580, e5800- Poverty: Chapter 1, e165

-Dementia (hc)

digestive system, b530- Obesity: chapter 5, functions related to the digestive system, b530

CGA-frailty (Kristjansson et al., 2012; original Balducci, Extermann, 2000, 2005)

*ADL: activity of daily living** CIRS:Cumulative Illness Rating Scale*** MMSE: Mini-mental state examination****GDS: Geriatric depression scale*****MNA: Mininutritional assessment

- Incontinence: Chapter 5, Functions related to the digestive system, b525, b5253; Chapter 6, Urinary functions, b620, b6202- MMSE***score<24: Chapter 1, Global mental functions: b117-GDS**** score >13: Chapter 1, Specific mental functions, b152

-Dependency for 1 or more ADL*:Bathing: Chapter 5, d510, d5101 Dressing: Chapter 5, d540, d5400, d5402, d5404 Toileting: Chapter 5, d530, d5300, d5301Transferring: Chapter 4, Changing and maintaining body position, d410, d4100, d4103Feeding: Chapter 5, d550-MNA*****< 17: Chapter 5, d570, d5701

- CIRS**Co-morbidity

HUBBARD scale/Chinese cohort (Woo et al., 2012; original Hubbard et al., 2010)

*bADL: basic activities of daily living**IADL: instrumental activities of daily living

- Continence (bADL*): Chapter 5, Functions related to the digestive system, b525, b5253; Chapter 6, Urinary functions, b620, b6202-No energy: Chapter 1, Global mental functions, b130,

-WalkingDaily or < 5 days a week or < 3-4 days a week or 2-3 blocks with difficulty, Chapter 4, d460, d4602- Help needed with bADL and/or IADL:- bADL*

No disease/≥1 chronic diseases (hc)

b1300 Bathing : Chapter 5, d510, d5101Dressing: Chapter 5, d540, d5400, d5402, d5404Toileting: Chapter 5, d530, d5300, d5301 Transferring: Chapter 4, Changing and maintaining body position, d420 FeedingChapter 5, d550- IADL** Ability to use telephone: Chapter3, Conversation and use of communication devices and techniques, d360, d3600 Shopping: Chapter 6, Acquisition of necessities, d620, d6200 Food preparation: Chapter 6, Household tasks, d630 Housekeeping: Chapter 6, Household tasks, d640

Laundry: Chapter 6, Household tasks, d640, d6400Transportation: Chapter 4, Moving around using transportation, d470, d475, Responsibility for own medications: Chapter 5, d570, d5702 Ability to handle finances: Chapter 8, Economic life, d860

Functional domains model/Health and Retirement Study HRS(Cigolle et al., 2009; original Strawbridge et al., 1998)

*TICS: telephone interview for cognitive status

- Physical functioning Dizziness: Chapter 2, Hearing and vestibular functions, b240, b2401- Nutritive functioningWeight loss ≥ 10% in previous 2 years: Chapter 5, functions related to the digestive system, b530BMI <18.5 kg/m²: Chapter 5, functions related to the digestive system, b530- Cognitive functioning (mild to severe impairment

- Physical functioning Difficulty lifting 10lbs: Chapter 4, Carrying, moving and handling objects, d430, d4300

-Physical functioning (≥2 falls in previous year) (hc)

based on TICS*):Chapter 1, Global mental functions, b117-Sensory problems Fair or poor eyesight despite use of corrective lenses: Chapter 2, Seeing and related functions, b210Fair or poor hearing despite use of hearing aids: Chapter 2, Hearing and vestibular functions, b230

Onco-Geriatric Screening Tool OGS(Valero et al., 2011)

-MalnutritionHas the patient lost 10% or more body weight over the past 6 months?: Chapter 5, functions related to the digestive system, b530Blood albumin level <35g/l: Chapter 5, functions related to the digestive system, b530- DepressionFeels sad or depressed: Chapter 1, Specific mental functions: b152Loss of interest in one of his/her usual

- Autonomy (help with everyday activities)Help with Washing: Chapter 5, d510, d5100, d5101Dressing: Chapter 5, d540, d5400, d5402, d5404Shopping: Chapter 6, Acquisition of necessities, d620, d6200Taking medication: Chapter 5, d570, d5702

- Autonomy (Fall in the course of the past 3 months) -hc- Co morbidity≥ 1 co-morbid conditions that are either unstable or untreatedTaking 4 or more medications

activities: Chapter 1, Global mental functions, b130, b1301- CognitionIs the patient unable to say what the date is?: Chapter 1, Global mental functions, b114, b1140Does the patient suffer from memory loss?: Chapter 1, Specific mental functions, b144

Reference test to the Onco-geriatric screening tool (Valéro et al., 2011)

*TUG: timed up and go**GDS: geriatric depression scale***MMSE:mini-mental state examination****MNA: mini nutritional assessment*****IADL: instrumental activities of daily living

-Depression (GDS**score >9): Chapter 1, Global mental function, b152-Cognition (MMSE***< 26):Chapter 1, Global mental functions: b117

-Autonomy(TUG* ≥20s): Chapter 4, Changing and maintaining body position, d410, d4103; Walking and moving, d450, d4500(IADL*****:2 negative responses)Toilet: Chapter 5, d530, d5300, d5301Feeding: Chapter 5, d550Dressing: Chapter 5, d540, d5400, d5402, d5404Grooming: Chapter 5, d520

-Co morbidity: ≥1 untreated or unstable co morbid condition (hc) > 4 medications

Physical ambulation: Chapter 4, Walking and Moving, d450, d455, d460Bathing: Chapter 5, d510, d5101Ability to use telephone: Chapter 3, Conversation and use of communication devices and techniques, d360, d3600Shopping: Chapter 6, Acquisition of necessities, d620, d6200Food preparation: Chapter 6, Household tasks, d630Housekeeping: Chapter 6, Household tasks, d640 Laundry: Chapter 6, Household tasks, d640, d6400 Mode of transportation: Chapter 4, Moving around using transportation, d470, d475 Responsibility for

own medications: Chapter 5, d570, d5702Ability to handle finances: Chapter 8, Economic life, d860-Malnutrition (MNA****≤23.5): Chapter 5, d570, d5701

Simple Frailty Score (Robinson et al., 2013)

-Mini-Cog ≤3: Chapter 1, Global mental functions: b117-Anemia (hematocrit <35%): Chapter 4, Functions of the hematological and immunological systems, 4301- Nutrition (albumin <3.4g/dL): Chapter 5, Functions related to the digestive system, b530

-Timed Up and GO ≥15s: Chapter 4, Changing and maintaining body position, d410, d4103; Walking and moving, d450, d4500-Katz scoreBathing: Chapter 5, d510, d5101Dressing: Chapter 5, d540, d5400, d5402, d5404Transferring: Chapter 4, Changing and maintaining body position, d420Walking: Chapter 4, Walking and Moving, d450Toileting: Chapter 5, d530, d5300, d5301Feeding: Chapter 5,

- Charlson Index ≥3- Falls ≥1 in 6 months previous to operation (hc)

d550Expanded Frailty Model (Amrock et al., 2014)

- Poor nutrition and inflammation (Albumin < 3.4g/dL): Chapter 5, Functions related to the digestive system, b530- BMI: Chapter 5, Functions related to the digestive system, b530- Muscle mass and chronic renal insufficiency (Creatinine >2mg/dL): Chapter 6, Urinary functions, b6100- Anemia (hematocrit <35%): Chapter 4, Functions of the hematological and immunological systems, 4301- Cognitive dysfunction (impaired sensorium): Chapter 1, Global mental functions, b117

-Functional status (assistance in activities of daily living): Chapter 5, Self-care

-Age-Sex-Race- Transfer status (fall risk and weakness)- Physical health and fitness (American Society of Anesthesiologists Physical Status Score ASA Class)

- Co morbidity index

Electronic Frailty Model (Amrock et al., 2014)

-BMI-Hematocrit-Albumin-Creatinine

-Age-Sex-Race-ASA Class

15 variable Trauma- -Health attitude -Daily activities - -Co morbidities

Specific Frailty Index TSFI (Joseph et al., 2014)

Feel less useful (most time, sometimes, never): Chapter 1, Specific mental functions, b152Feel sad (most time, sometimes, never): Chapter 1, Specific mental functions, b152Feel effort to do everything (most time, sometimes, never): Chapter 1, Global mental functions, b1300, b1301Feel lonely (most time, sometimes, never): Chapter 1, Specific mental functions, b152-Co-morbiditiesCoronary heart disease (myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, medication, no medication) - Chapter 4, Functions related to the cardiovascular system, b410, b4103-Nutrition (albumin

Help with grooming: Chapter 5, d520Help managing money: Chapter 8, Economic life, d860Help doing household work: Chapter 6, Household tasks, d640Help toileting: Chapter 5, d5300, d5301Help walking(Wheelchair, walker, cane, none): Chapter 4, Walking and moving, d450, d465

Cancer history (yes, no) (hc)Dementia (severe, moderate, mild, none)(hc)-Falls (most times, sometimes, never)(hc)-Function, sexually active (yes, no)

<3 or >3): Chapter 5, Functions related to the digestive system, b530

CSBA index /Easy Prognostic Indicator (Forti et al., 2012; original Ravaglia et al., 2008)

*IADL: instrumental activities of daily living

- Sensory deficits: Chapter 2, Seeing and related functions; Hearing and vestibular functions; Additional sensory functions

-Calf circumference <31cm: Chapter 7, s750, s7501, s75012

- Physical inactivity: Chapter 5, d570, d5701- Difficulty with any IADL*: Ability to use telephone: Chapter 3, Conversation and use of communication devices and techniques, d360, d3600 Shopping: Chapter 6, Acquisition of necessities, d620, d6200Food preparation: Chapter 6, Household tasks, d630Housekeeping: Chapter 6, Household tasks, d640 Laundry: Chapter 6, Household tasks, d640, d6400Mode of transportation: Chapter 4, Moving around using transportation,

- Poor self- perceived health- Age > 80 years- Male gender

- Daily use of ≥3 drugs- Poor physical performance

d470, d475Responsibility for own medications: Chapter 5, d570, d5702Ability to handle finances: Chapter 8, Economic life, d860

Conselice Study of Brain Aging Score/Modified easy prognostic score (Lucicesare et al., 2010; original Ravaglia et al., 2008)

As above (Easy prognostic score) excluding age and gender

Kihon checklist (Fukutomi et al., 2013)

-Nutritional status:Has your weight declined by 2-3 kg in the past 6 months?: Chapter 5, functions related to the digestive system, b530BMI: Chapter 5, functions related to the digestive system, b530- Oral function Have you experienced more difficulty chewing tough foods than you did 6 months ago?: Chapter 5, functions related to the digestive system,

-Physical strength:Are you able to go up the stairs without using handrails or the wall for support?: Chapter 4, walking and moving, d455, d4551Are you able to stand up from a sitting position without support?: Chapter 4, changing and maintaining body position, d410, d4103Are you able to walk continuously for 15 minutes?:

-Physical strength:Have you experienced a fall in the past year? (hc)-House-boundness:Do you go out at least one time a week?Do you go out less often than you did last year?

b510, b5102Do you ever experience choking or coughing when drinking tea or soup?: Chapter 5, functions related to the digestive system, b510, b5105, Chapter 4, Additional functions and sensations of the cardiovascular and respiratory systems, b450Are you bothered by feeling of thirst or dry mouth?: Chapter 5, functions related to the digestive system, b510, b5104- Cognitive functionDo you sometimes not know what the date is?: Chapter 1, global mental functions, b114, b1140Do others point out your forgetfulness or tell you “you always ask the same thing”: Chapter 1, Specific mental functions, b144-Depression risk(In the past 2 weeks

Chapter 4, walking and moving, d450, d4501Do you use public transportation (bus or train) to go out on your own?: Chapter4, moving around using transportation, d470, d4702Do you shop for daily necessities?: Chapter 6, acquisition of necessities, d620, d6200Do you manage financial matters such as savings or deposits by yourself?: Chapter 8, economic life, d860Do you visit the homes of friends? : Chapter 4, walking and moving, d460, d4602- Cognitive function:When you want to make a call, do you usually search for the telephone number and call on your own?:

things that you could do easily before are now difficult; you cannot enjoy things that you enjoyed before; you do not feel that you are a useful person; you feel exhausted for no apparent reason; you feel no sense of fulfilment in your life): Chapter 1, Global mental functions, b152-Physical strengthDo you feel anxious about falling when you walk?: Chapter 1, Global mental functions, b152, Chapter 4, walking and moving, d450 (activities and participation)

Chapter 3, conversation and use of communication devices and techniques, d360, d3600- Do you give advice to friends or family members who confide in you?: Chapter 6, caring for household objects and assisting others, d660

Barber Questionnaire (Molina –Garrido, Guillen-Ponce, 2011; original Barber et al., 1980, 1981)

- Do you have difficulty with vision?: Chapter 2, Seeing and related functions, b210- Do you have difficulty with hearing?: Chapter 2, hearing and vestibular functions, b230

- Are you without a relative you could call on for help?: Chapter 3, e310, e315- Have you been in hospital during the past year?: Chapter 5, e580, e5800

- Do you live on your own?- Are you confined to your home through ill health?- Is there anything about your health causing you concern or

- Do you depend on someone for regular help?- Are there any days when you are unable to have a hot meal?

difficulty?Sherbrooke Postal Questionnaire(Metzelthin et al., 2010;Daniels et al., 2012; original Hébert et al., 1996)

- Do you see well?: Chapter 2, Seeing and related functions, b210- Do you hear well?: Chapter 2, Hearing and vestibular functions, b230- Do you have problems with your memory?: Chapter 1, Specific mental functions, b144

- Do you regularly use a cane, a walker or a wheelchair to move about?: Chapter 4, Walking and moving, d465

- Do you live alone?

- Do you take more than three different medications every day?

INTER-FRAIL (Di Bari et al., 2014)

- Poor vision: Chapter 2, Seeing and related functions, b210- Self report of exhaustion: Chapter 1, Global mental functions, b1300- Memory problems: Chapter 1, Specific mental functions, b144- Unintentional weight loss in prior year: Chapter 5, functions related to the digestive system, b530

-Difficulty walking 400m: Chapter 4, Walking and moving, d450, d4500

- Hospitalization in previous year: Chapter 5, e580, e5800- Persons available to provide help: Chapter 3

- Not living alone - Fall in prior year (hc)- Taking ≥5 drugs

Vulnerable Elders Scale VES-13/Acove Frailty Score (Kellen et al., 2010; Molina-Garrido, Guillen-Ponce, 2010;

- ActivitiesNeeds help inreaching or extending arm above shoulder: Chapter 7, Mobility of

- ADLs/IADLs Needs help in Bathing: Chapter 5, d510, d5101Shopping: Chapter

- Self-reported health (good or excellent; fair or poor)- Age (75-84

Sternberg et al., 2012; original Saliba et al., 2000, 2001)

joints and bones, b710; Chapter 4, Carrying, moving and handling objects, d445, d4452 (activities and participation)

6, Acquisition of necessities, d620, d6200 Managing money: Chapter 8, Economic life, d860Transferring (difficulties walking across the room): Chapter 4, Walking and moving, d460, d4600Light housework: Chapter 6, Household tasks, d640-Activities Needs help in Stooping, crouching, kneeling: Chapter 4, Changing and maintaining body position, d410, d4102, d4105Doing heavy housework: Chapter 6, Household tasks, d640Writing or handling small objects: Chapter 1, Applying knowledge, d170; Chapter 4, Carrying, moving and handling objects, d440

years; ≥85 years)

Walking ¼ mile: Chapter 4, Walking and moving, d450, d4500Lifting or carrying 10lbs: Chapter 4, Carrying, moving and handling objects, d430

Modified VES-13/Modified Scoring(S. -L. Ma et al., 2009)

Same items as VES-13 excluding age

Groningen Frailty Indicator (GFI) (Kellen et al, 2010; Metzelthin et al, 2010; Daniels et al, 2012; original Steverink et al, 2001)

- VisionProblems in daily life because of impaired vision: Chapter 2, Seeing and related functions, b210- HearingProblems in daily life because of impaired hearing: Chapter 2, Hearing and vestibular functions, b230- NutritionWeight loss in the past 6 months: Chapter 5, functions related to the digestive system, b530-Psychosocial:Does the patient ever experience

- MobilityHelp with grocery shopping: Chapter 6, Acquisition of necessities, d620, d6200Walking outside house: Chapter 4, Walking and moving, d450, d460, d4602, d465Dressing and undressing: Chapter 5, d540Visiting restroom: Chapter 5, d530, d5300, d5301

-PsychosocialDoes the patient ever feel left alone? (E.g. you wish there was someone to go with you to something important): Chapter 3, Support and relationships

- Physical fitnessHow would the patient rate his/her physical fitness?

- Co-morbidityDoes the patient take ≥ 4 different types of medication?-Cognition Diagnosed with dementia (hc)

emptiness around him/her?: Chapter 1, Specific mental functions: b152Has the patient felt nervous or anxious lately? : Chapter 1, Specific mental functions: b152Has the patient been feeling down or depressed lately? : Chapter 1, Specific mental functions: b152Does the patient ever miss the presence of other people around him/her? Or do you miss anyone you love? : Chapter 1, Specific mental functions: b152- CognitionMemory complaints: Chapter 1, Special mental functions, b144

Self-assessment version of GFI(Peters et al., 2012)

- Physical componentDo you experience problems in daily life due to poor vision: Chapter 2, Seeing and related functions, b210Do you experience problems in daily life

- Physical componentAre you able to carry out these tasks single-handedly and without any help?Shopping: Chapter 6, Acquisition of

-Social component Will other people help you if you are in need?: Chapter 3, Support and relationships

- Physical componentWhat mark do you give yourself for physical fitness?-Social componentIf you are at

- Physical componentDo you take ≥ 4 different types of medicine?- Social componentDo other people pay attention to

because of being hard of hearing: Chapter 2, Hearing and vestibular functions, b230During the past 6 months have you lost a lot of weight unwillingly: Chapter 5, functions related to the digestive system, b530-Cognitive componentDo you have complaints about your memory: Chapter 1, Special mental functions, b144-Psychological componentIn the past 4 weeks did you feel Downhearted or nervous?: Chapter 1, Specific mental functions: b152Calm and relaxed?: Chapter 1, Specific mental functions, b152

necessities, d620, d6200Walking around outside: Chapter 4, Walking and moving, d450, d460, d4602, d465Dressing and undressing: Chapter 5, d540Going to the toilet: Chapter 5, d530, d5300, d5301

work, with your family, or at church do you believe that you are part of the social network

you?

Tilburg Frailty Indicator (Daniels et al., 2012;Gobbens et al., 2012;Metzelthin et al., 2010;

- - - - What is the highest level of education you have completed?: Chapter 8,

- Which category indicates your monthly net household income?:

- Sex- Age-Marital status-Country where you were born

- ≥ 2 chronic diseases or illnesses (hc)

original Gobbens et al., 2010)Part A (Determinants of frailty)

Part B (Components of frailty)

- Physical componentHave you lost a lot of weight recently without wishing to do so?: Chapter 5, Functions related to the digestive system, b530Do you experience problems in your daily life due to Difficulties maintaining your balance?: Chapter 2, Hearing and

Education, d820, d830- How healthy would you say your lifestyle is? : Chapter 5, d570

- Physical componentDo you experience problems in your daily life due to difficulty in walking?: Chapter 4, Walking and moving, d450

Chapter 1, e165, e1650

- Social component:Do you sometimes miss having people around you?: Chapter 3, Support and relationshipsDo you receive enough support from other people?: Chapter 3, Support and

- Have you experienced ≥ 1 of the following events during the last year: Death of a loved oneA serious illness yourself?A serious illness of a loved one?A traffic accidentA crimeA divorce or ending of an important intimate relationship- Are you satisfied with your home living environment?

- Physical componentDo you feel physically healthy?- Psychological componentAre you able to cope with problems well?- Social componentDo you live alone?

vestibular functions, b235, b2351Due to poor hearing?: Chapter 2, Hearing and vestibular functions, b230Due to poor vision?: Chapter 2, Seeing and related functions, b210Due to lack of strength in your hands? : Chapter 7, b730, b7300Due to physical tiredness?: Chapter 4, Additional functions and sensations of the cardiovascular and respiratory systems, b455, b4552- Psychological component Do you have problems with your memory?: Chapter 1, Special mental functions, b144Have you felt down during the last months?: Chapter 1, Specific mental functions, b152Have you felt nervous or anxious during the last

relationships

month? : Chapter 1, Specific mental functions, b152

Modified Short Emergency Geriatric Assessment (SEGAm) instrument (Oubaya et al., 2014; original Schoevaerdts et al., 2004))

- Mood: Chapter 1, Specific mental functions, b152-Nutrition: Chapter 5, Functions related to the digestive system, b530; Chapter 1, Global mental functions, b1302-Urinary/faecal incontinence: Chapter 5, Functions related to the digestive system, b525, b5253; Chapter 6, Urinary functions, b620, b6202-Cognitive function: Chapter 1, Global mental functions: b117

- IADLPreparing meals: Chapter 6, Household tasks, d630Using telephone: Chapter 3, Conversation and use of communication devices and techniques, d360, d3600Taking own medications: Chapter 5, d570, d5702Transport: Chapter 4, Moving around using transportation, d470, d475-Mobility: Chapter 4, walking and moving; Chapter 4, changing and maintaining body position, d450, d410, d4103-Meals: Chapter 5, d550

-Age-Origin-Perception of won health compared to others of the same age

-Medications-Fall in the last 6 months (hc)-Associated diseases (hc)

Identification of Seniors At Risk ISAR(Salvi et al., 2012;

- Is your vision usually good?: Chapter 2, Seeing and

- Have you needed more help (for personal care) than

- Have you been hospitalized for ≥ 1 days during

- Do you use >3 different types of medicine/day?

original McCusker et al., 1999)

related functions, b210- Do you usually have serious memory problems?: Chapter 1, Global mental functions, b144,

usual to be able to take care of yourself after the illness arose which caused the hospitalization?: Chapter 5, Self-care

the last 6 months, not including visits to the casualty ward?: Chapter 5, e580, e5800- Have you needed help on a regular basis (from home care, home nurse, relatives or others) prior to the illness that caused the hospitalization?: Chapter 5, e575, e5750

Modified Changes in Health, End-Stage Diseaseand Symptoms and Signs of medical problems CHESS (Hogan et al., 2012; original Hirdes et al., 2003)

- Vomiting: Chapter 5, Functions related to the digestive system, b510, b5106- Dehydration (only in original): Chapter 5, Functions related to metabolism and the endocrine system, b545, b5450- Weight loss: Chapter 5, Functions related to the digestive system, b530- Shortness of breath: Chapter 4, Additional functions and sensations of the

- Worsening of decision making over previous 90 days: Chapter 1, Applying knowledge, d177- Decline in activities of daily living over previous 90 days:- Bathing: Chapter 5, d510, d5101- Dressing: Chapter 5, d540, d5400, d5402, d5404- Toileting: Chapter 5, d530, d5300, d5301- Transferring:

- Decline in food/fluid intake (only in original)- Oedema- End-stage disease (hc)

cardiovascular and respiratory systems, b460- Decline in activities of daily living over previous 90 days:Continence: Chapter 5, Functions related to the digestive system, b525, b5253; Chapter 6, Urinary functions, b620, b6202

Chapter 4, Changing and maintaining body position, d420- Feeding: Chapter 5, d550

CGA (Smets et al., 2014;original Solomon 1988)*MMSE: Mini-mental state examination**GDS: Geriatric Depression Scale***ADL: Activities of daily living****IADL: Instrumental Activities of daily living

-CognitionMMSE* score ≤23: Chapter 1, Global mental functions: b117-DepressionGDS-15** score ≥8: Chapter 1, Specific mental functions, b152-NutritionWeight loss of ≥1kg over past 3 months: Chapter 5, Functions related to the digestive system, b530-Functional domainA problem in ≥2 items in ADL*** using Barthel Index or IADL**** using Lawton ScaleADL

-Functional domainA problem in ≥2 items in ADL*** using Barthel Index or IADL**** using Lawton ScaleADL:Bathing: Chapter 5, d510, d5101Dressing: Chapter 5, d540, d5400, d5401, d5402, d5403Toileting: Chapter 5, d530, d5300, d5301Transferring from wheelchair to bed and vice versa: Chapter 4, Changing and maintaining body position, d420, d4200

- Use of ≥3 medications- Nutrition decline in food intake during last week

Controlling bowels: Chapter 5, Functions related to the digestive system, b525, b5253Controlling bladder: Urinary functions, Chapter 6, b620, b6202

Feeding: Chapter 5, d550Grooming: Chapter 5, d520Ascend and descend stairs: Chapter 4, Walking and moving, d455, d4551Walking on level surface: Chapter 4, Walking and moving, d450IADLAbility to use telephone: Chapter 3, Conversation and use of communication devices and techniques, d360, d3600Shopping: Chapter 6, Acquisition of necessities, d620, d6200Food preparation: Chapter 6, Household tasks, d630Housekeeping: Chapter 6, Household tasks, d640 Laundry: Chapter 6, Household tasks, d640, d6400

Mode of transportation: Chapter 4, Moving around using transportation, d470, d475Responsibility for own medications: Chapter 5, d570, d5702 Ability to handle finances: Chapter 8, Economic life, d860

aCGA (Smets et al.,2014;original Overcash et al., 2005)

- GDS (4 items):Do you feel that your life is empty?: Chapter 1, Specific mental functions, b152Do you feel happy most of the time?: Chapter 1, Specific mental functions, b152Do you often feel helpless?: Chapter 1, Specific mental functions, b152Do you feel pretty worthless the way you are now?: Chapter 1, Specific mental functions, b152-MMSE (4 items)Attention and

-ADLBathing: Chapter 5, d510, d5101Transfer: Chapter 4, Changing and maintaining body position, d420-IADLShopping: Chapter 6, Acquisition of necessities, d620, d6200Prepare own meals: Chapter 6, Household tasks, d630Housework: Chapter 6, Household tasks, d640Laundry: Chapter 6, Household tasks, d640, d6400

calculation: Chapter 1, Specific mental functions, b140, b1400; Chapter 1, Specific mental functions, b172, b1720-ADLContinence: Chapter 5, Functions related to the digestive system, b525, b5253; Chapter 6, Urinary functions, b620, b6202

-MMSEReading: Chapter 1, Applying knowledge, d166Writing: Chapter 1, Applying knowledge, d170Copying: Chapter 1, d130

G8 (Smets al al., 2014; original Soubeyran et al., 2008)

-Has food intake declined over the past 3 months due to loss of appetite, digestive problems, chewing, or swallowing difficulties? : Chapter 1, Global mental functions, b1302; Chapter 5, functions related to the digestive system, b515, b5102, b5105-Weight loss during last 3 months? : Chapter 5, Functions related to the digestive system, b530-BMI: Chapter 5,

-Mobility: Chapter 4, walking and moving

- In comparison with other people of same age how do you consider your health status?-Age

-Neuro-psychological problems: (hc)- Takes >3 prescription drugs/day

Functions related to the digestive system, b530

Frailty Index for Elders FIFE (Tocchi et al., 2014)

-Without wanting to, have you lost or gained 10lbs in the last 6months? : Chapter 5, Functions related to the digestive system, b530-Do you have mouth or tooth problems that make it hard to eat? : Chapter 5, Functions related to the digestive system, b510- Do you have a poor appetite and quickly feel full when you eat? : Chapter 1, Global mental functions, b130, b1302- Do you get tired easily? : Chapter 1, Global mental functions, b130, b1300

-Do you need help getting in and out ofbed? : Changing and maintaining body position, d410, d4100-Do you need help with washing or bathing? : Chapter 5, d510, d5101-Did your physical health or emotional problems interfere with your social activities?: d920, d9205 (d5702, b152)

- Where you hospitalised in the last 3 months? : Chapter 5, e580, e5800- Did you visit an emergency room for a health problem in the past 3 months? : Chapter 5, e580, e5800

- Would you say your health is fair or poor?

Multidimensional Frailty Score MFS (Kim et al., 2014)

- Dementia (MMSE): Chapter 1, Global mental functions, b117-Risk of delirium (nursing delirium screening scale):

-Midarm circumference: Chapter 7, s730, s7300, s7302

-ADLs (modified Barthel Index)Grooming: Chapter 5, d520Bathing: Chapter 5, d510, d5101Eat: Chapter 5,

-Malignant disease (hc)-Charlson co-morbidity Index (hc)

Chapter 1, Global mental functions, b110-ADLs (modified Barthel Index)Faecal and urinary incontinence: Chapter 5, Functions related to the digestive system, b525, b5253; Chapter 6, Urinary functions, b620, b6202- Albumin: Chapter 5, Functions related to the digestive system, b530

d550Dressing: Chapter 5, d540, d5400, d5401, d5402, d5403Toilet use: Chapter 5, d530, d5300, d5301Go up and down the stairs: Chapter 4, Walking and moving, d455, d4551Walking in a hallway: Chapter 4, Walking and moving, d450-IADLs (Lawton and Broody Index)Using telephone: Chapter 3, Conversation and use of communication devices and techniques, d360, d3600Shopping: Chapter 6, Acquisition of necessities, d620, d6200Transport: Chapter 4, Moving around using transportation, d470, d4702, d475, d4751

Use of medication: Chapter 5, d570, d5702Financial management: Chapter 8, Economic life, d 860Prepare food: Chapter 6, Household tasks, d630Laundry: Chapter 6, Household tasks, d640, d6400Housekeeping: Chapter 6, Household tasks, d640-Mini-Nutritional Assessment: Chapter 5, d570, d5701

The Frailty Trait Scale FTS (Garcia-Garcia et al., 2014)*PASE: Physical Activity Scale for the Elderly

- Energetic balance/nutritionBody mass index: Chapter 5, Functions related to the digestive system, b530Weight loss: Chapter 5, Functions related to the digestive system, b530Abdominal obesity: Chapter 5, Functions related to the

-StrengthGrip strength: Chapter 4, Carrying, moving and handling objects, d4401-Endurance (chair test): Chapter 4, changing and maintaining body position, d4103

-Gait speed (walking speed): Chapter 4, Walking and moving, d450, d4500Chapter 5, d5701-Activity (PASE*):Chapter 5, d5701

digestive system, b530Albumin serum levels (mg/dl): Chapter 5, Functions related to the digestive system, b530- Nervous systemFluency (number of animals in 60s): Chapter 3, b3300Progressive Romberg Test: Chapter 2, Hearing and vestibular functions, b2351;Additional sensory function, b260-Vascular system Brachial ankle index: Chapter 4, Functions of the cardiovascular system, b4150-StrengthKnee extension strength: Chapter 7, muscle functions, b7303

Physical frailty score(Carriere et al., 2005)

- Physical activity in MET/week: Chapter 5, Functions related to metabolism and the endocrine system, b540, b5400- BalanceTime to complete 10 Foot taps: Chapter 7,

- Calf circumference: Chapter 7, s750, s7501, s75012

- StrengthGrip strength: Chapter 4, Carrying, moving and handling objects, d440, d4401- Mobility

- Educational level (obtaining old French Certificate of Elementary Education): Chapter 8, Education, d820- MobilityGait speed

- Perceived healthSelf –rated healthHealth compared to women of same age- Fear of falling

- Body compositionWaist/hip circumferenceFat mass/body massLean mass/body massBMI change

Movement functions b755, b760, b7602,Standing and dynamic balance: Chapter 2, Hearing and vestibular functions, b235, b2351- Binocular visual acuity (at 5 m): Chapter 2, Seeing and related functions, b210, b2100, b21000- Body compositionBMI: Chapter 5, Functions related to the digestive system, b530Weight: Chapter 5, Functions related to the digestive system, b530- StrengthQuadriceps strength: Chapter 7, muscle functions, b730, b7303

Chair stands: Chapter 4, changing and maintaining body position, d410, d4103

(walking 6m at normal pace): Chapter 4, Walking and moving, d450, d4500

Weight change-MobilitySteps to walk 6m length

Modified Physical Performance Test + VO₂peak + ADL(Villareal et al., 2004)

*bADL: Basic activities of daily living**IADL: instrumental activities of daily living

- Peak aerobic power (VO₂peak): Chapter 4, Additional functions of the cardiovascular and respiratory systems, b455, b4551- Continence (bADL): Chapter 5, Functions related to the digestive system,

- 50 feet walk: Chapter 4, Walking and moving, d450, d4500- Putting on and removing laboratory coat: Chapter 5, d540, d5400, d5401- Pick up penny

- Turn 360°

b525, b5253; Chapter 6, Urinary functions, b620, b6202

from the floor: Chapter 2, Changing and maintaining body position, d4101, d4105, Chapter 4, Carrying, moving and handling objects, d440, d4400- Chair rise: Chapter 4, Changing and maintaining body position, d410, d4103- Book lift: Chapter 4, Carrying, Moving and handling objects, d430, d4300- Climbing one flight of stairs: Chapter 4, Walking and moving, d455, d4551-Standing with feet side-by-side, semi-tandem, and full-tandem with eyes open: Chapter 4, Changing and maintaining body position, d415, d4154- Climbing four flights of stairs:

Chapter 4, Walking and moving, d455, d4551- bADL*Bathing:Chapter 5, d510, d5101Dressing:Chapter 5, d540, d5400, d5402, d5404Toileting:Chapter 5, d530, d5300, d5301 Transferring: Chapter 4, Changing and maintaining body position, d420Feeding: Chapter 5, d550- IADL**Ability to use telephone: Chapter 3, Conversation and use of communication devices and techniques, d360, d3600Shopping: Chapter 6, Acquisition of necessities, d620, d6200Food preparation: Chapter 6, Household tasks,

d630Housekeeping: Chapter 6, Household tasks, d640 Laundry: Chapter 6, Household tasks, d640, d6400Mode of transportation: Chapter 4, Moving around using transportation, d470, d475Responsibility for own medications: Chapter 5, d570, d5702Ability to handle finances: Chapter 8, Economic life, d860

Modified FRAIL Scale/ Chinese cohort (Woo et al., 2012; Morley J.E. et al., 2012; original Abellan Van Kan et al., 2008)

- Reporting no energy: Chapter 1, Global mental functions, b130, b1300- BMI < 18.5kg/m²: Chapter 5, functions related to the digestive system, b530

- Ambulation Cannot walk 2-3 blocks: Chapter 4, walking and moving, d450, d4500- Resistance Cannot climb up 10 steps: Chapter 4, walking and moving, d455, d4551

- >5 diseases (hc)

Seven potential frailty criteria (Rothman MD et al., 2008)

- Weight loss (> 10 pounds in the past year): Chapter 5,

- Slow gait speed (walking 10 feet as fast

-Physical activity (PASE*): Chapter 5, d570, d5701

*PASE: Physical Activity Scale for the Elderly (measurement of physical activity)**CES-D: Center of Epidemiologic Studies Depression Scale***MMSE: Mini Mental State Examination

Functions related to the digestive system, b530- MMSE *** <24: Chapter 1, Global mental functions, b117- Exhaustion: (CES-D ): Chapter 1, Global Mental functions, b130, b1300- Depressive symptoms (11 item CES-D): Chapter 1, Specific mental functions, b152

as possible): Chapter 4, Walking and moving, d450, d4500- Grip strength (weakness): Chapter 4, Carrying, moving and handling objects, d440, d4401

Marigliano-Cacciafesta polypathology scale (MCPS)(Martocchia et al., 2013; original Amici et al., 2008)

*MNA: mini nutritional assessment

- Cardiopathy (NYHA): Chapter 4, Functions of the cardiovascular system, b410, b4102; Additional functions and sensations of the cardiovascular and respiratory systems, b455, b460- Respiratory disorders: Chapter 4, Functions of the respiratory system: b440; Additional functions and sensations of the cardiovascular and respiratory systems, b450, b455, b460- Renal disorders:

- Gastroenteritic disorders: Chapter 5, s520, s530, s540

-Metabolism and nutritional stateSevere malnutrition: Chapter 5, d570, d5701MNA* ≤23: Chapter 5, d570, d5701

- Neurological disordersMulti-infarct encephalopathy, stroke, Parkinson’s disease, cranial trauma, post-traumatic epilepsy (hc)- Malignant cancerous disorders (hc)-Degenerative or inflammatory arthropathy (hc)- Metabolism and nutritional state:Diabetes (hc)-Cognitive state and mood:

Chapter 6, Urinary functions, b610, b6100- Episodes of urinary incontinence: Chapter 6, Urinary functions, b620, b6202- Locomotive apparatus disorders:Pain: Chapter 2, Pain, b280, b2801, b28016Joint mobility: Chapter 7, Functions of the joints and bones, b710- Sensory deprivation (sight and hearing): Chapter 2, Seeing and related functions, b210; Chapter 2, Hearing and vestibular functions, b230- Metabolism and nutritional state: BMI > 25: Chapter 5, Functions related to the digestive system, b530Anaemia: Chapter 4, Functions of the haematological and immunological systems, b430, 4301- Cognitive state and mood:

Depression with psychosis/dementia (hc)Depression/Anxiety (hc)

Compromised cognition: Chapter 1, Global mental functions, b117- Peripheral vascular system: Chapter 4, Functions of the cardiovascular system, b415, b4150, b4152; Chapter 8, Functions of the skin, b810- Gastroenteritic disorders: Chapter 5, Functions related to the digestive system, b515, b520, b525, b535

Frailty based on sensor data(Greene et al., 2014)

-Balance: Chapter 2, Hearing and vestibular functions, b235, b2351

-Five-times-sit-to-stand: Chapter 4, changing and maintaining body position, d4103

- Timed up and go: Chapter 4, Changing and maintaining body position, d410, d4103; Walking and moving, d450, d4500

Phenotype of frailty/Cardiovascular Health Study CHS (original Fried et al., 2001; Kulminski et al., 2008; Makary et al., 2010; Nemoto et al., 2011; Collerton et al., 2012)

*MLTAQ: Minnesota Leisure

- Unintentional weight loss/shrinking: Chapter 5, Functions related to the digestive system, b530- Exhaustion (CES-D**): Chapter 1, Global mental functions, b130,

- Grip strength (weakness): Chapter 4, Carrying, moving and handling objects, d440, d4401

- Slowness (walking speed over 15 feet): Chapter 4, Walking and moving, d450, d4500

Time Activities Questionnaire**CES-D: Center of Epidemiologic Studies Depression Scale

b1300- Low physical activity (MLTAQ*): Chapter 5, Functions related to metabolism and the endocrine system, b540, b5400

Phenotype of frailty(Modified by Hogan et al., (2012)

- Unintentional weight loss/shrinking: Chapter 5, Functions related to the digestive system, b530- Exhaustion (3 questions): Chapter 1, Global mental functions, b130, b1300


- Slowness (walking speed over 3 meters): Chapter 4, Walking and moving, d450, d4500- Low physical activity (reported in minutes over 2 weeks): Chapter 5, d570, d5701

Composite A/ Phenotype of frailty(Modified by Purser et al., 2006)

*MOS-SF: Medical Outcomes Study-Short FormCES-D**: Centre for Epidemiologic Studies Depression Scale

- Unintentional weight loss: Chapter 5, Functions related to the digestive system, b530- Exhaustion (CES-D**): Chapter 1, Global mental functions, b130, b1300


-Mobility(walking speed over 15 feet at a preferred pace): Chapter 4, Walking and moving, d450, d4500

- Physical activity limitations due to health conditions (MOS-SF*)

Phenotype of frailty(Modified by Woo et al., 2012)

*PASE: Physical Activity Scale for the Elderly (measurement of physical activity)

- BMI < 18.5kg/m²: Chapter 5, Functions related to the digestive system, b530- Self reported no energy: Chapter 1,

- Grip strength (weakness): Chapter 4, Carrying, moving and handling objects, d440,

- Slowness (walking speed over 15 feet): Chapter 4, Walking and moving, d450, d4500-Low energy

Global mental functions, b130, b1300

d4401 expenditure (PASE*): Chapter 5, d570, d5701

Phenotype of frailty(Modified by Kristjansson et al., 2012)

*TUG: Timed Up and Go**EORT QLQ: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Core 30MNA***: Mini nutritional assessment

- Weight loss > 3kg during last 3 months (MNA***): Chapter 5, Functions related to the digestive system, b530- Exhaustion (EORT QLQ-C30**): Chapter 1, Global mental functions, b130, b1300


- Slowness (TUG* >19s): Chapter 4, Changing and maintaining body position, d410, d4103; Walking and moving, d450, d4500- Low activity (EORTC QLQ-C30**): Chapter 5, d570, d5701

Phenotype of frailty(Modified by Ensrud et al., 2007, 2009)

*PASE: Physical Activity Scale for the Elderly (measurement of physical activity)**GDS: Geriatric Depression Scale***based on a modified version of Harvard Alumni Questionnaire

- Shrinking/ unintentional weight loss of ≥5% between examinations: Chapter 5, Functions related to the digestive system, b530- Poor energy (GDS** – do you feel full of energy?): Chapter 1, Global mental functions, b130, b1300-Low physical activity/2007 (Kilocalories/week***): Chapter 5, Functions related to metabolism and the endocrine system, b540, b5400


- Slowness (Walking speed): Chapter 4, Walking and moving, d450, d4500-Low physical activity /2009(PASE*): Chapter 5, d570, d5701

Phenotype of frailty(Modified by Avila-Funes et al., 2009)

*CES-D: Centre for Epidemiologic Studies Depression Scale

- Weight loss of ≥3kg or BMI <21 kg/m²: Chapter 5, Functions related to the digestive system, b530- Exhaustion (CES-D*): Chapter 1, Global mental functions, b130, b1300

- Slowness (Walking speed over 6m at usual pace): Chapter 4, Walking and moving, d450, d4500- Low physical activity (doing leisure activities or participating in athletic activity): Chapter 5, d570, d5701; Chapter 9, d920, d9201- Weakness (difficulty rising from a chair): Chapter 4, Changing and maintaining body position, d410, d4103

Phenotype of frailty /Mobilise Boston Study MBS(Modified by Kiely et al., 2009)

*PASE: Physical Activity Scale for the Elderly (measurement of physical activity)

**CESD-R: Centre for Epidemiological Studies Depression Scale, Hopkins Revsion

- Unintentional weight loss > 10 pounds in previous year: Chapter 5, Functions related to the digestive system, b530- Exhaustion/low energy level (CESD-R**): Chapter 1, Global mental functions, b130, b1300

- Weakness (sit-stand test time): Chapter 4, changing and maintaining body position, d410, d4103

- Slowness (timed 4m walk): Chapter 4, Walking and moving, d450, d4500- Daily activity (PASE*): Chapter 5, d570, d5701

Phenotype of frailty(Modified by Savva et al., 2013)

*CES-D: Centre for Epidemiological Studies Depression Scale

- Weight loss: Chapter 5, Functions related to the digestive system, b530- Exhaustion (CES-D*): Chapter 1, Global mental functions, b130, b1300- Low physical activity in kcal expenditure/week (International Physical Activity Questionnaire) : Chapter 5, Functions related to metabolism and the endocrine system, b540, b5400


- Slowness (walking speed 16ft at usual pace): Chapter 4, Walking and moving, d450, d4500

Phenotype of frailty(Modified by Gruenewald et al., 2009)

*YPAS: Yale Physical Activity Survey (measurement of physical activity)

- Weight loss (percentage of body weight lost or gained during the 3 year follow up period): Chapter 5, Functions related to the digestive system, b530- Exhaustion (1 item of the Hopkins Symptom Checklist): Chapter 1, Global mental functions, b130, b1300


- Slowness (10 foot walk at usual pace): Chapter 4, Walking and moving, d450, d4500- Physical activity (YPAS*): Chapter 5, d570, d5701

Phenotype of frailty(Modified by Woods et al., 2005)

- Unintentional weight loss >5% of body weight in

-Weakness(Rand -36 Physical Function Scale):

-Weakness (Rand -36 Physical Function Scale):

previous 2 years: Chapter 5, Functions related to the digestive system, b530- Exhaustion (Rand 36 Vitality Scale score <55): Chapter 1, Global mental functions, b130, b1300- Low physical activity (kcal/week expended on leisure time activity): Chapter 5, Functions related to metabolism and the endocrine system, b540, b5400

Strength to lift: chapter 4, carrying, moving and handling objects, d430, d4300Strength to carry: Chapter 4, carrying, moving and handling objects, d430, d4301, d4302, d4303Strength to stoop: Chapter4, changing and maintaining body position, d410, d4105Strength to bend: Chapter4, changing and maintaining body position, d410, d4105Strength to stair climb: Chapter 4, Walking and moving d455, d4551Ability to walk various distances: Chapter 4, Walking and moving, d450, d4500, d4501, d460Self-care: Chapter 5

Health limits physical function in moderate/vigorous activity

Phenotype of frailty(Modified by Buchman et al., 2011)

- Body mass index: Chapter 5, Functions related to the

- Grip strength (weakness): Chapter 4,

- Slowness (walking speed over 8 feet):

*CES-D: Center of Epidemiologic Studies Depression Scale

digestive system, b530- Fatigue (CES-D*): Chapter 1, Global mental functions, b130, b1300

Carrying, moving and handling objects, d440, d4401

Chapter 4, Walking and moving, d450, d4500

Phenotype of frailty(Modified by Graham et al., 2009)

*PASE: Physical Activity Scale for the Elderly (measurement of physical activity)**CES-D: Center of Epidemiologic Studies Depression Scale

- Unintentional weight loss of ≥ 4.5kg in 1 year: Chapter 5, Functions related to the digestive system, b530- Exhaustion (CES-D**): Chapter 1, Global mental functions, b130, b1300

- Grip strength (weakness): Chapter 4, Carrying, moving and handling objects, d440, d4401- Walking at a fast pace for 4.9m: Chapter 4, Walking and moving, d450, d4500

-Physical activity (PASE*): Chapter 5, d570, d5701

Phenotype of frailty/ Frail-CHS (Modified by Rockwood et al., 2006, 2007)

*TUG: Timed Up and Go

- Weight loss of ≥ 10lbs or ≥5% of body weight in past year: Chapter 5, Functions related to the digestive system, b530- Weakness (abnormal strength on physical examination): Chapter 7, Muscle functions, b730-Exhaustion, Feeling tired all the time: Chapter 1, Global mental functions,

- Slowness (TUG*): Chapter 4, Changing and maintaining body position, d410, d4103; Walking and moving, d450, d4500- Low physical activity (needing assistance with walking or not being able to walk): Chapter 4, Walking and moving, d450, d465

b130, b1300Biologic syndrome Model (Cigolle et al., 2009)

- Weight loss ≥ 10% in previous 2 years or BMI < 18.5kg/m²: Chapter 5, Functions related to the digestive system, b530- Exhaustion: Chapter 1, Global mental functions, b130, b1300


- Slowness (walking speed over 8 feet): Chapter 4, Walking and moving, d450, d4500- Low energy expenditure (frequency and intensity of mild, moderate and vigorous physical activities): Chapter 5, d570, d5701

Adapted Fried using questionnaire data from RAND-36/SF-36/ Helsinki Businessmen Study (Sirola et al., 2010)

- Weight loss of > 5% from baseline or current BMI <21kg/m2: Chapter 5, Functions related to the digestive system, b530- Exhaustion (RAND-36 vitality scale): Chapter 1, Global mental functions, b130, b1300

- Physical activity (Do you exercise regularly weekly?): Chapter 5, d570, d5701- Physical weakness (self- reported difficulty in carrying or lifting a grocery bag (RAND-36 physical function scale): Chapter 4, Carrying, moving and handling objects, d430, d4300, d4301, d4302, d4303

Gill Frailty Index (Kim et al., 2014; original Gill et al., 2002)

-Sit-to-stand test: Chapter 4, changing and

-Walk 10 feet: Chapter 4, Walking and moving, d4500

maintaining body position, d410, d4103

Zutphen Elderly Study(Chin A Paw et al., 1999)

- Weight loss of >4kg in 5 years: Chapter 5, Factors related to the digestive functions, b 530- BMI <23.5kg/m²: Chapter 5, Factors related to the digestive functions, b 530- Food intake converted into energy < 7.6 MJ/day: Chapter 5, Functions related to metabolism and the endocrine system, b540

- Physical activity<210min/week: Chapter 5, d570, d5701

Modified Physical Performance Test(Brown et al., 2000; original Reuben DB, Siu AL, 1990)

- Progressive Romberg test: Chapter 2, Hearing and vestibular functions, b235, b2351;Additional sensory function, b260

- Book lift: Chapter 4, Carrying, Moving and handling objects, d430, d4300- Put on and take off a coat: Chapter 5, d540, d5400, d5401- Pick up penny: Chapter 2, Changing and maintaining body position, d4105, Chapter 4, Carrying, moving and handling objects, d440, d4400

- Turn 360°

- Chair rise: Chapter 4, Changing and maintaining body position, d410, d4103- 50 feet walk: Chapter 4, Walking and moving, d450, d4500- One flight of stairs: Chapter 4, Walking and moving, d455, d4551- Four flights of stairs: Chapter 4, Walking and moving, d455, d4551

Short Physical Performance Battery (Chang et al., 2013)

- Back scratch flexibility test: Chapter 7, Functions of joints and bones, b710, b7101

- Grip strength: Chapter 4, Carrying, moving and handling objects, d440, d4401- 8-foot up and go test: Chapter 4, Changing and maintaining body position, d410, d4103; Walking and moving, d450, d4500-30s chair stand test: Chapter 4, changing and

maintaining body position, d410, d4103

Timed up and Go TUG(Savva et al., 2013 ; original Podsiadlo D, Richardosn S., 1991)

- Timed up and go: Chapter 4, Changing and maintaining body position, d410, d4103; Walking and moving, d450, d4500

FI-SOF (Ensrud et al., 2009; Kiely et al., 2009; Bilotta et al., 2010; Pilotto et al., 2012; original Ensrud et al., 2008)

*GDS: Geriatric depression scale

- Weight loss of ≥ 5% between baseline and 2nd examination/ Unintentional weight loss > 4.5 kg/10lbs during last year: Chapter 5, functions related to the digestive system, b530- Poor energy (GDS*): Chapter 1, Global mental functions, b130, b1300

- Inability to rise from a chair 5 times without using hands: Chapter 4, changing and maintaining body position, d410, d4103

mSOF index (Forti et al., 2012)

-Do you feel full of energy: Chapter 1, Global mental functions, b130, b1300-Tinetti test score ≤ 24:Balance: Chapter 2, Hearing and vestibular functions, b235, b2351;

- Malnutrition Calf circumference < 31cm: Chapter 7, s750, s7501, s75012

Gait: Chapter 7, Movement functions, b770

hc: health condition

Documents

· Web viewEach deficit is dichotomized (present or absent) or trichotomized and coded in the interval 0 to 1. The total score is the number of deficits present divided by