Frailty Index Calculator

Comprehensive frailty assessment for older adults based on the cumulative deficit model (Rockwood Frailty Index).

Example Case: 78-year-old with multiple chronic conditions

Click to load this example case for demonstration

Demographic Information

years
Patient age in years (recommended 60+)
60 78 years 120
Biological sex for reference comparisons
Current living arrangement

Comprehensive Geriatric Assessment Deficits

Select all deficits that apply to the patient. Frailty Index = (number of deficits selected) / (total deficits assessed).

Comorbidities & Symptoms
Chronic diseases and symptoms
Hypertension
Blood pressure >140/90 or on antihypertensives
Diabetes Mellitus
Type 1 or 2 diabetes, on treatment
Heart Failure
Congestive heart failure, any stage
Coronary Artery Disease
History of MI, angina, or revascularization
Stroke/TIA
History of cerebrovascular event
COPD/Asthma
Chronic obstructive pulmonary disease
Arthritis
Osteoarthritis or rheumatoid arthritis
Osteoporosis
History of fragility fracture or DXA confirmed
Chronic Kidney Disease
Stage 3+ (eGFR <60 mL/min)
Dementia/Cognitive Impairment
MMSE <24 or clinical diagnosis
Depression
Geriatric Depression Scale >5
Visual Impairment
Corrected vision <20/40
Hearing Impairment
Difficulty hearing normal conversation
Urinary Incontinence
Weekly or more frequent leakage
Recurrent Falls
2+ falls in past year
Functional Status & Mobility
ADLs, IADLs, and mobility deficits
Bathing Dependence
Needs help with bathing
Dressing Dependence
Needs help with dressing
Toileting Dependence
Needs help with toilet use
Transfer Dependence
Needs help moving bed/chair
Continence Dependence
Needs help with continence
Feeding Dependence
Needs help with eating
Medication Management
Cannot manage own medications
Financial Management
Cannot manage finances
Transportation Dependence
Cannot use transportation independently
Housework Dependence
Cannot do light housework
Walking Limitations
Difficulty walking 1/4 mile
Stair Climbing Difficulty
Cannot climb one flight of stairs
Balance Problems
Difficulty with tandem stand
Weak Grip Strength
Below gender/age-adjusted norms
Fatigue/Exhaustion
Feels exhausted most of the time
Nutritional Status
Nutritional deficits and weight changes
Significant Weight Loss
>5% weight loss in past year
Low BMI
BMI <18.5 kg/m²
High BMI
BMI >30 kg/m²
Poor Appetite
Eats less than half of meals
Swallowing Difficulties
Choking or coughing with food/liquid
Clinical Malnutrition
MNA score <17
Dehydration Risk
Fluid intake <1500 mL/day
Low Albumin
Serum albumin <3.5 g/dL
Social & Psychological Factors
Social support and psychological factors
Social Isolation
Sees family/friends <1x/week
Loneliness
Feels lonely often or always
Caregiver Stress
Primary caregiver is stressed
Financial Stress
Difficulty meeting basic needs
Anxiety
Excessive worry most days
Sleep Disturbance
Difficulty falling/staying asleep
Polypharmacy
Taking ≥5 medications daily
Medication Non-adherence
Misses >20% of prescribed doses
Polypharmacy (≥5 medications) is associated with frailty
Recent hospitalizations increase frailty risk
Calculating frailty assessment...

Understanding the Frailty Index

The Frailty Index (FI) is a comprehensive geriatric assessment tool based on the cumulative deficit model developed by Dr. Kenneth Rockwood and colleagues. It quantifies frailty as the proportion of health deficits present in an individual relative to the total number of deficits considered.

Key Concept: Frailty represents a state of increased vulnerability to stressors due to age-associated declines in physiological reserve across multiple organ systems. It is distinct from both disability and multimorbidity, though related to both.

Frailty Index Calculation

Frailty Index Formula:
FI = (Number of deficits present) / (Total number of deficits assessed)
Where: Each deficit is scored as 0 (absent) or 1 (present)
Frailty Index Range Classification Clinical Meaning 1-Year Mortality
0.00 - 0.10 Robust Minimal deficits, good physiological reserve 1-3%
0.10 - 0.21 Pre-frail Some deficits, reduced physiological reserve 4-8%
0.21 - 0.45 Frail Significant deficits, limited physiological reserve 9-25%
>0.45 Severely Frail Multiple deficits, minimal physiological reserve 26-50%+

Age-Specific Frailty Patterns

Age Group Average FI Frail Prevalence Clinical Implications
60-69 0.10 - 0.15 5-10% Early intervention can delay progression
70-79 0.15 - 0.25 15-25% Comprehensive geriatric assessment indicated
80-89 0.25 - 0.35 30-45% High risk for adverse outcomes, need close monitoring
90+ 0.35 - 0.50+ 50-70% Focus on quality of life and symptom management

Clinical Applications of Frailty Assessment

Preoperative Assessment
Predicts surgical outcomes, complications, and recovery time. Guides decisions about surgical intervention versus conservative management.
Medication Management
Informs medication prescribing, deprescribing decisions, and identifies patients at high risk for adverse drug reactions.
Discharge Planning
Predicts post-hospitalization outcomes and guides appropriate discharge destinations and support services.
Prognostication
Provides estimates of survival, hospitalization risk, and functional decline to guide care planning discussions.
Geriatric Syndromes
Identifies patients at risk for falls, delirium, incontinence, and other geriatric syndromes for targeted interventions.
Advance Care Planning
Facilitates discussions about goals of care, treatment preferences, and end-of-life planning based on prognosis.