1. Frailty and Its Potential Relevance to Cardiovascular Care
Mandeep Singh, MD, MPH, Karen Alexander, MD, Véronique L. Roger, MD, MPH, Charanjit S. Rihal, MD, Heather E. Whitson, MD, Amir Lerman, MD, Arshad Jahangir, MD, K. Sreekumaran Nair, MD 
Mayo Clinic Proceedings 
Volume 83, Issue 10, Pages (October 2008)
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2. FIGURE 1
Trajectories of health and functioning. Full performance = high functional reserve that allows patients to face environmental perturbations with ease; frailty = patients are at high risk of homeostasis disruption and consequent negative health outcomes, including disability and death, probably from exhaustion of functional reserve. From J Endocrinol Invest,9 with permission from the Italian Society of Endocrinology.
aCan be physical, cognitive, social, or quality of life.
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3. FIGURE 2
Cycle of frailty combines elements of body composition, nutrition, and mobility into a pathophysiologic pathway. In this pathway, sarcopenia and poor muscle strength, by limiting mobility and physical activity, reduce total energy expenditure and nutritional intake, thereby causing weight loss and further sarcopenia. In defining frailty, involvement of musculoskeletal system is central and paramount. Loss of movement capacity frequently accelerates decline in other organ systems. From J Gerontol A Biol Sci Med Sci,1 with permission of the Gerontological Society of America. Copyight © 2001.
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4. FIGURE 3
The Longitudinal Aging Study Amsterdam demonstrated poor survival rates among both men and women who were frail according to 9 frailty markers defined as static or dynamic and who consisted of 2257 respondents participating in 2 cycles: T1 in and T2 in A, Survival according to frailty status at T2. B, Survival according to frailty status at T1-T2. Fom J Am Geriatr Soc,49 with permission from Wiley-Blackwell Publishing.
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5. FIGURE 4
Canadian comprehensive sampling of 9008 community residents. Adjustments have been made for age and sex. Frailty scale in this study is based on geriatric status scale and demonstrates dose-response relationship between grades of frailty and subsequent institutionalization and death. 0 = those who walk without help, perform activities of daily living (ADL), are continent, and are not cognitively impaired; 1 = those with bladder incontinence only; 2 = those with 1 (2 if incontinent) or more of the following: need for assistance with mobility or ADL, cognitive impairment with dementia, or bowel or bladder incontinence; 3 = those with 2 (3 if incontinent) or more of totally dependent for transfers or 1 or more ADL, incontinence of bowel and bladder, and diagnosis of dementia. From The Lancet,50 with permission from Elsevier Limited.
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