Frailty criteria

The best known measurement scale for "Frailty" is from Fried LP et al (2001). Here, a distinction is made between a beginning "Frailty" ("Prefrailty") and the actual "Frailty". If only 2 of the criteria are met, the condition is referred to as prefrailty syndrome; if 3 or > 3 criteria are met, the condition is referred to as frailty syndrome. The definition according to Fried (Fried LP et al. 2001) focuses on physiological criteria (e.g. strength, endurance), which is justified for the assessment of risks such as falls or medical interventions. However, frailty can also include a social or psychological "frailty".

Another clinically useful classification is the CSHA (Clinical Frailty Scale), which distinguishes 7 levels. Its validity corresponds approximately to that of more complex scales (Buta BJ et al. 2015).

Frailty criteria according to Fried (2001). According to Fried, frailty can be assumed if at least 3-5 of the following leading symptoms are present:

• Unintended weight loss of > 5 kg/year, or according to the German Nutrition Society defined as weight loss of > 5% in 3 months or > 10% in 6 months.
• Decrease in gross body strength (hand strength measurement 20% compared to the reference population)
• Subjectively felt exhaustion
• Reduced walking speed (5 m walking distance with 20% of the speed of the comparable population), in terms of reduced mobility
• Reduced general activity
• If there are only 1 or 2 criteria, one speaks of so-called prefrailty.

"Frailty" or infirmity is understood to mean the simultaneous occurrence of various, sometimes disease-related limitations that make older people less resilient (in terms of health) and thus more susceptible to illness, disability or falls (Xue QL 2011). The age syndrome "Frailty" is defined by a decrease in performance in the different organ systems, which causes increased vulnerability due to a negative outcome. The older organism increasingly loses its ability to perform or compensate. It becomes more susceptible to diseases, possibly with repeated hospital stays, with the need for care, with increased mortality."Frailty" as a syndrome is now accepted worldwide.

1. Fried LP et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56: M146-M156