ArticleAge and ageing2023
How to construct a frailty index from an existing dataset in 10 steps.
Article in Age and ageing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 118 papers.
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Who cites it
118 citing papers in PubMed.
- Frailty and Recurrent Cardiovascular Events in Patients With Obstructive Sleep Apnoea: The SAVE Study.Journal of cachexia, sarcopenia and muscle · 2026Trial
- Article
- How human and animal frailty index studies can inform each other: a brief narrative review.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Review
- Frailty index deficit interchangeability: an empirical test using random survival forests in adults with cardiovascular disease.Age and ageing · 2026Article
- Higher cystatin C, but not creatinine, predicts frailty risk in individuals with normal kidney function.The Journal of frailty & aging · 2026Article
- Association of an estimated glucose disposal rate-frailty index with incident cardiovascular events in two prospective cohorts.International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- Association of the combined triglyceride-glucose and frailty index with chronic kidney disease: evidence from two national cohort studies.Endocrine · 2026Article
- Comparing frailty index distribution, mortality and frailty dynamics across multiple countries: applying the 'zero-state' principle to harmonised ageing data.Age and ageing · 2026Article
- Regional Variation in the Prevalence of Frailty Among Very Old Adults in Germany: Findings of the Nationwide Study "Old Age in Germany" (D80+).Deutsches Arzteblatt international · 2026Observational
- Frailty Index and Risk of Ischemic Stroke in China: Evidence from a Cohort Study, Disease Burden Analysis, and Mendelian Randomization.Healthcare (Basel, Switzerland) · 2026Article
- Association of the Frailty-to-Estimated Cardiorespiratory Fitness Ratio with Prevalent Stroke in Middle-Aged and Older Adults: A Cross-Sectional NHANES Study.Bioengineering (Basel, Switzerland) · 2026Article
- Age-adjusted leukocyte telomere length predicts long-term mortality in older patients discharged from acute care hospitals.GeroScience · 2026Article
- Development and validation of a multidimensional physical function-focused frailty at risk index for early detection of functional decline in community-dwelling older adults.Scientific reports · 2026Article
- Combined effect of the triglyceride-glucose index and frailty index on advanced stages among cardiovascular-kidney-metabolic syndrome patients.Journal of cardiothoracic surgery · 2026Article
- The Living Lab Concept in the Detection, Prevention and Monitoring of Geriatric Syndromes in Elderly Patients with Cardiovascular Disease-A Narrative Review.Journal of clinical medicine · 2026Review
- Deficit accumulation frailty and risk of incident chronic kidney disease: a prospective analysis of the UK biobank and CHARLS cohorts.International urology and nephrology · 2026Article
- Joint association of frailty and social isolation with depressive symptoms among middle-aged and older Chinese adults: a nationwide cohort study.Scientific reports · 2026Article
- Frailty among older adults in Germany: regional variation across NAKO study centers.International journal for equity in health · 2026Article
- The Effect Modification of Systolic Blood Pressure on the Association of Frailty and Cardiovascular Disease in Community-Dwelling Adults.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Declining kidney function and frailty progression: a 7-year cohort study of Chinese middle-aged and older adults.The Journal of frailty & aging · 2026Article
58 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors.
Funding
Abstract
backgroundThe frailty index is commonly used in research and clinical practice to quantify health. Using a health deficit accumulation model, a frailty index can be calculated retrospectively from data collected via survey, interview, performance test, laboratory report, clinical or administrative medical record, or any combination of these. Here, we offer a detailed 10-step approach to frailty index creation, with a worked example.
methodsWe identified 10 steps to guide the creation of a valid and reliable frailty index. We then used data from waves 5 to 12 of the Health and Retirement Study (HRS) to illustrate the steps.
resultsThe 10 steps are as follows: (1) select every variable that measures a health problem; (2) exclude variables with more than 5% missing values; (3) recode the responses to 0 (no deficit) through 1 (deficit); (4) exclude variables when coded deficits are too rare (< 1%) or too common (> 80%); (5) screen the variables for association with age; (6) screen the variables for correlation with each other; (7) count the variables retained; (8) calculate the frailty index scores; (9) test the characteristics of the frailty index; (10) use the frailty index in analyses. In our worked example, we created a 61-item frailty index following these 10 steps.
conclusionsThis 10-step procedure can be used as a template to create one continuous health variable. The resulting high-information variable is suitable for use as an exposure, predictor or control variable, or an outcome measure of overall health and ageing.
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