Geriatric assessment
Frailty Index (Deficit Accumulation)
The frailty index counts health deficits to quantify vulnerability. Select each deficit that applies to your patient based on history, exam, and assessments. The ratio of present deficits to total items represents frailty severity.
Frailty index
0.40 (6 / 15)
Severe frailtyHigh vulnerability to adverse outcomes. Consider comprehensive geriatric assessment, care coordination, and advanced care planning.
How to Use This Calculator
Gather a comprehensive history
Include medical diagnoses, functional status, psychosocial supports, and validated screening results.
Mark each deficit present
Deficits count if they are chronic or recurrent. Temporary issues less than 6 months typically do not count.
Interpret the frailty ratio
Higher ratios indicate greater vulnerability and guide interventions like exercise, nutrition, and medication optimization.
Formula
Frailty Index = Number of deficits present ÷ Total deficits assessed
Thresholds: <0.12 robust, 0.12–0.24 prefrail, 0.25–0.35 moderate frailty, >0.36 severe frailty (approximate ranges).
Include at least 30 deficits in formal research; this tool provides a pragmatic 15-item screening set for clinical use.
Full Description
Deficit accumulation captures the multidimensional nature of frailty encompassing physical, cognitive, emotional, and social factors. The more deficits an individual has, the higher the risk for falls, hospitalization, and mortality. Frailty assessment supports proactive care planning and patient-centered discussions.
Use the frailty index alongside performance measures (e.g., gait speed, grip strength) and clinician judgement. Interventions include resistance exercise, protein supplementation, deprescribing, vision/hearing optimization, and community resources to maintain independence.
Frequently Asked Questions
How many deficits are needed for a reliable index?
Research recommends ≥30 items. This 15-item tool is a pragmatic screen—expand with additional deficits for research-grade assessments.
Can I mix objective tests and self-report?
Yes. Combine lab values, performance tests, and validated questionnaires to build a holistic deficit list.
How often should frailty be reassessed?
At least annually or after major health events (hospitalization, surgery, falls).
Does frailty reverse?
Frailty can improve with targeted interventions (exercise, nutrition, social engagement). Track scores to monitor progress.