Identifying frailty in high functioning older adults with normal mobility.

SIR—The concept of ‘frailty’ has been used to identify older adults at increased risk for disability [1, 2]. A major obstacle to developing primary prevention strategies for frailty is the lack of clinical markers of early frailty, especially among high functioning older adults. The Physical Performance Battery (PPB) has been reported to predict disability in older adults [3, 4], but its association with early stages of frailty is not well established. We examined the validity of PPB to identify frailty in nondisabled and nondemented community-residing older adults. Slow gait is the most easily identifiable feature of frailty [2, 3, 5], but may occur later in the disablement process [6–8]. To assess the ability of PPB to capture mild or very early stages of frailty, we further restricted our sample to older adults with normal walking speeds.