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1 Division of Geriatric Medicine,2 Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Address correspondence to Kenneth Rockwood, MD, Centre for Health Care of the Elderly, 1421-5955 Veterans' Memorial Lane, Halifax, Nova Scotia, Canada, B3H 2E1. E-mail: Kenneth.Rockwood{at}Dal.ca
This review article summarizes how frailty can be considered in relation to deficit accumulation. Recalling that frailty is an age-associated, nonspecific vulnerability, we consider symptoms, signs, diseases, and disabilities as deficits, which are combined in a frailty index. An individual's frailty index score reflects the proportion of potential deficits present in that person, and indicates the likelihood that frailty is present. Although based on a simple count, the frailty index shows several interesting properties, including a characteristic rate of accumulation, a submaximal limit, and characteristic changes with age in its distribution. The frailty index, as a state variable, is able to quantitatively summarize vulnerability. Future studies include the application of network analyses and stochastic analytical techniques to the evaluation of the frailty index and the description of other state variables in relation to frailty.
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