An operational definition of frailty predicted death, hip fracture, and hospitalization in older women.

M e t h o d s Design: Prospective cohort study. Setting: 40 clinical centers in the United States. Participants: 40 657 women 65 to 79 years of age who did not have Parkinson disease and did not take medication for Parkinson disease or depression and were expected to survive and live in the same area for ≥ 3 years. Risk factors: Frailty, defined as having ≥ 3 of 5 frailty components: muscle weakness and slow walking speed (score < 75 out of 100 on the RAND-36 physical function scale, counts as 2 components), exhaustion (score < 55 out of 100 on the RAND-36 vitality scale), low physical activity (Kcal of weekly energy expenditure in the lowest quartile, calculated from a detailed physical activity questionnaire), or unintentional weight loss (> 5% of body weight in the previous 2 y). Outcomes: Death, hip fracture, and overnight hospitalization during the followup period. M a i n r e s u l t s At baseline, 16% of women were considered to be frail and 28% to be intermediate (1 or 2 frailty components). At 3 years, frailty had developed in 15% of women with < 3 frailty components at baseline. Frailty at baseline increased risk for death, hip fracture, and hospitalization during the mean 5.9 years of follow-up (Table). Intermediate frailty was also a predictor of these outcomes, to a lesser extent (Table). C o n c l u s i o n In older women, the operational definition of frailty was associated with increased risk for death, hip fracture, and hospitalization.