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Recently, we modified this approach to develop a new method to quantify frailty with a frailty index based on deficit accumulation in a mouse model of aging ( 10). One approach to quantify frailty in older people is to construct a “frailty index,” in which an individual’s potential health deficits (eg, clinical signs, diseases, laboratory abnormalities) are counted and divided by the total number of items measured ( 1, 8, 9). In fact, more than 20 different instruments have been used to measure frailty clinically ( 7). How best to measure frailty in people is controversial ( 6). Indeed, the need to develop measures of frailty in aging animal models has been identified as a key step to translate basic mechanisms of cellular dysfunction in aging into meaningful treatments ( 5). Still, little is known about the biology of frailty, in part because until recently frailty had not been quantified in animal models of aging. Frailty is a major challenge in health care as frail individuals have higher mortality and use more health care services than do fit people ( 4). The concept of frailty, which is a state of increased vulnerability to adverse health outcomes for people of the same age, was developed to explain the heterogeneity in clinical outcomes for older patients ( 3). Because chronological age does not necessarily reflect biologic age, the health status of older adults varies from fit to frail ( 1, 2). Unlike the performance-based eight-item mouse FI, the clinical FI exhibits key features of the FI established for use in humans.Į xperience tells us that people age at different rates.
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This noninvasive FI based on clinical measures can be used in longitudinal studies to quantify frailty in mice. The exponential relationship between FI scores and age (normalized to 90% mortality) was similar in mice and humans for the clinical FI but not the eight-item FI. FI scores calculated from 70 self-report items from the first wave of the Survey of Health, Ageing and Retirement in Europe were plotted as function of age ( n = 30,025 people). By contrast, the increase was graded with a 31-item clinical FI (0.02☐.005 at 5 months 0.12☐.008 at 19 months 0.33☐.02 at 28 months n = 14). FIs calculated with the original performance-based eight-item FI increased from 0.06☐.01 at 5 months to 0.36☐.06 at 19 months and 0.38☐.04 at 28 months ( n = 14). Here we developed a simplified, noninvasive method to quantify frailty through clinical assessment of C57BL/6J mice (5–28 months) and compared the relationship between FI scores and age in mice and humans.
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We previously quantified frailty in aged mice with frailty index (FI) that used specialized equipment to measure health parameters.