Protocol - Frailty

Description:

The SOF Frailty Index is an assessment of frailty based on an individual's weight change over the past three years, physical ability to perform five chair stands without using arms for support, and energy level. If the individual meets two of the three criteria (weight loss of 5% or more, inability to do chair stands, low/lack of energy), the individual is considered frail.

Specific Instructions:

Frailty can occur at younger ages than the traditional 65-year cutpoint for "older" and certainly does not need to be restricted to the SOF age (69 years of age and older).

Protocol:

Weight loss

What was your weight 3 years ago? __ __ __ lbs
What is your weight today? __ __ __ lbs
[Interviewer/computer: calculate weight loss percentage] Change in weight (Q1-Q2)/weight 3 years ago (Q1)

= ___ __ % loss

Ability to do 5 chair stands

4. [Interviewer: Ask respondent to sit in chair, then rise up without using arms, repeat 4 more times.] Was respondent able to do chair stands without assistance? Yes or No

Energy level

5. Do you feel full of energy? Yes or No

Scoring

Q1. Score = 1 if weight loss ? 5%, otherwise, score = 0

Q2. Score = 1 if unable to do chair stands without assistance (No), otherwise, score = 0

Q3. Score = 1, if No, otherwise, score = 0

If summed score is 2 or 3, respondent is frail;

if score is 1 respondent is pre-frail;

if score is 0, respondent is robust.

Protocol Name from Source:

Study of Osteoporotic Fractures (SOF) Frailty Index

Availability:

Publicly available

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Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a "don't know" response is provided.

Equipment Needs

The PhenX Working Group acknowledges that these questions can be administered in a computerized or noncomputerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire. Chair for chair stands

Requirements

Requirement Category	Required
Major equipment	No
Specialized training	No
Specialized requirements for biospecimen collection	No
Average time of greater than 15 minutes in an unaffected individual	No

Mode of Administration

Interviewer-administered questionnaire

Life Stage:

Pregnancy

Participants:

69 years of age and older

Selection Rationale

This well-established protocol has been used on a large prospective cohort study of older adults.

Language

English

Standards

Standard	Name	ID	Source
Common Data Elements (CDE)	Osteoporosis Study of Osteoporotic Fractures Frailty Index Assessment Score	6360511	CDE Browser

Derived Variables

None

Process and Review

The Expert Review Panel has yet to review this measure.

Source

National Institute on Aging, Study of Osteoporotic Fractures (SOF) Frailty Index

General References

Ensrud, K. E., Ewing, S. K., Taylor, B. C., Fink, H. A., Cawthon, P. M., Stone, K. L., ... Cummings, S. R. (2008). Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Archives of Internal Medicine,168(4), 382-9

Ensrud, K. E., Ewing, S. K., Cawthon, P. M., Fink, H. A., Taylor, B. C., Cauley, J. A., ... Osteoporotic Fractures in Men Research Group. (2009). A comparison of frailty indexes for the prediction of falls, disability, fractures, and mortality in older men. Journal of the American Geriatric Society, 57(3), 492-498.

Protocol ID:

251001

Variables:

Export Variables

Variable Name	Variable ID	Variable Description	dbGaP Mapping
PX251001_Frailty_Ability_Chair_Stands	PX251001040000	[Interviewer: Ask respondent to sit in chair, then rise up without using arms, repeat 4 more times.] Was respondent able to do chair stands without assistance?	N/A
PX251001_Frailty_Energy_Level	PX251001050000	Do you feel full of energy?	N/A
PX251001_Frailty_Weight_Loss_Percentage	PX251001030000	[Interviewer/computer: calculate weight loss percentage] Change in weight (Q1-Q2)/weight 3 years ago (Q1) ___ __ % loss	N/A
PX251001_Frailty_Weight_Three_Years_Ago	PX251001010000	What was your weight 3 years ago? __ __ __ lbs	N/A
PX251001_Frailty_Weight_Today	PX251001020000	What is your weight today? __ __ __ lbs	N/A

Geriatrics

Measure Name:

Frailty

Release Date:

N/A

Definition

Declines in physiologic complexity or reserve in body systems, leading to loss of homeostatic capability to withstand stressors and resulting vulnerabilities.

Purpose

Frailty is associated with weakness and the inability to perform normal daily activities, particularly in older adults. Frailty leads to increased morbidity and mortality.

Keywords

Activities of Daily Living, ADLs, Frailty Index, Study of Osteoporotic Fractures (SOF), weakness, geriatrics, falls, National Institute on Aging, NIA, gerontology, aging