The Frailty Index for Elders (FIFE)
The risk for becoming frail increases as older adults live longer with chronic illnesses. Frailty is a geriatric syndrome affecting older adults due to multisystem decline that increases vulnerability to poor health effects. Although there is not a universal gold standard definition of frailty, there are two main definitions currently accepted. The Phenotype of Frailty identifies older adults as frail if they have three or more of five criteria and being at risk for frailty is having one or two criteria: slow walking speed, weak grip strength, exhaustion, low physical activity level, and unintentional weight loss (Fried et al., 2001). Alternately, a Frailty Index includes cognition, mood and social resources with physiological components in defining frailty (Rockwood et al.,2005). The hallmark of frailty is its progressive decline marked by loss of function, loss of physiological reserve, increased risk for falls, delayed illness recovery, more frequent and longer stay hospitalization, and mortality. Even small stressors of temperature change or the common cold may precipitate a spiraling downward trajectory for frail older adults with significant impact on the quality of life of the older adult and families. Once frail, it is difficult to reverse the downward decline. Therefore, it is essential to recognize older adults at risk for frailty in the clinical setting. Early recognition of older adults at risk for frailty can lead to interventions that may prevent or ameliorate frailty.