Skip to main content

The multiple dimensions of frailty: physical capacity, cognition, and quality of life

  • Francis Langlois (a1) (a2), Thien Tuong Minh Vu (a2) (a3), Marie-Jeanne Kergoat (a2), Kathleen Chassé (a2), Gilles Dupuis (a1) (a4) and Louis Bherer (a1) (a2)...

Background: Frailty is a complex health state of increased vulnerability associated with adverse outcomes such as disability, falls, hospitalization, and death. Along with physical impairments, cognition and quality of life may be affected in frail older adults. Yet, evidence is still lacking. The aim of this study was to compare frail and non-frail older adults on physical, cognitive, and psychological dimensions.

Methods: Thirty-nine frail and 44 non-frail elders were compared on several measures of physical capacity, cognition, and quality of life. Frailty status was based on a geriatric examination and scored using the Modified Physical Performance Test.

Results: After controlling for demographic and medical characteristics, physical capacity measures (i.e. functional capacities, physical endurance, gait speed, and mobility) were significantly lower in frail participants. Frail participants showed reduced performances in specific cognitive measures of executive functions and processing speed. On the quality of life dimension, frail elders reported poor self-perceptions of physical capacity, cognition, affectivity, housekeeping efficacy, and physical health.

Conclusion: In addition to the reduced physical capacity, frailty might affect selective components of cognition and quality of life. These dimensions should be investigated in intervention programs designed for frail older adults.

Corresponding author
Correspondence should be addressed to: Francis Langlois, CRIUGM, 4545 Queen Mary, Montreal, QC H3W 1W4, Canada. Phone: +1-514-340-2800 (4048); Fax: +1-514-340-3548. Email:
Hide All
Bergman, H. et al. (2007). Frailty: an emerging research and clinical paradigm – issues and controversies. The Journals of Gerontology Series A: Medical Science, 62, 731737.
Bohannon, R. W. (1997). Comfortable and maximum walking speed of adults aged 20–79 years: reference values and determinants. Age and Ageing, 26, 1519.
Bohnen, N., Jolles, J., and Twijnstra, A. (1992). Modification of the Stroop Color Word Test Improves Differentiation Between Patients with Mild Head Injury and Matched Controls. Lisse, Pays-Bas: Swets & Zeitlinger.
Brown, M., Sinacore, D. R., Binder, E. F. and Kohrt, W. M. (2000). Physical and performance measures for the identification of mild to moderate frailty. The Journals of Gerontology Series A: Medical Science, 55, M350M355.
Cesari, M. et al. (2006). Frailty syndrome and skeletal muscle: results from the Invecchiare in Chianti study. American Journal of Clinical Nutrition, 83, 11421148.
Chang, C. I., Chan, D. C., Kuo, K. N., Hsiung, C. A. and Chen, C. Y. (2010). Vitamin D insufficiency and frailty syndrome in older adults living in a Northern Taiwan community. Archives of Gerontology and Geriatrics, 50 (Suppl 1), S17S21.
Duquette, R. L., Dupuis, G. and Perrault, J. (1994). A new approach for quality of life assessment in cardiac patients: rationale and validation of the Quality of Life Systemic Inventory. Canadian Journal of Cardiology, 10, 106112.
Edwards, J. D., Delahunt, P. B. and Mahncke, H. W. (2009). Cognitive speed of processing training delays driving cessation. The Journals of Gerontology Series A: Medical Science, 64, 12621267.
Enright, P. L. et al. (2003). The 6-min walk test: a quick measure of functional status in elderly adults. Chest, 123, 387398.
Ferrucci, L., Windham, B. G. and Fried, L. P. (2005). Frailty in older persons. Genus, 61, 3953.
Fillenbaum, G. G. and Smyer, M. A. (1981). The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. Journal of Gerontology, 36, 428434.
Folstein, M., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.
Fried, L. P. et al. (2001). Frailty in older adults: evidence for a phenotype. The Journals of Gerontology Series A: Medical Science, 56, M146M156.
Fried, L. P., Ferrucci, L., Darer, J., Williamson, J. D. and Anderson, G. (2004). Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. The Journals of Gerontology Series A: Medical Science, 59, 255263.
Hays, R. D., Hahn, H. and Marshall, G. (2002). Use of the SF-36 and other health-related quality of life measures to assess persons with disabilities. Archives of Physical Medicine and Rehabilitation, 83, S4S9.
Jokinen, H. et al. (2011). Incident lacunes influence cognitive decline: the LADIS study. Neurology, 76, 18721878.
Leng, S. X., Hung, W., Cappola, A. R., Yu, Q., Xue, Q. L. and Fried, L. P. (2009). White blood cell counts, insulin-like growth factor-1 levels, and frailty in community-dwelling older women. The Journals of Gerontology Series A: Medical Science, 64, 499502.
Masel, M. C., Graham, J. E., Reistetter, T. A., Markides, K. S. and Ottenbacher, K. J. (2009). Frailty and health related quality of life in older Mexican Americans. Health and Quality of Life Outcomes, 7, 70.
Matusik, P. et al. (2011). Severe frailty and cognitive impairment are related to higher mortality in 12-month follow-up of nursing home residents. Archives of Gerontology and Geriatrics. Epublished ahead of print. doi:10.1016/j.archger.2011.06.034
Miyake, A., Emerson, M. J. and Friedman, N. P. (2000). Assessment of executive functions in clinical settings: problems and recommendations. Seminars in Speech and Language, 21, 169183.
Podsiadlo, D. and Richardson, S. (1991). The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39, 142148.
Reitan, R. M. (1958). Validity of the trail making test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271276.
Rey, A. (1941). L'examen psychologique dans les cas d'encéphalopathie traumatique. Archives de Psychologie, 28, 21.
Rochat, S. et al. (2010). Frailty and use of health and community services by community-dwelling older men: the Concord Health and Ageing in Men Project. Age and Ageing, 39, 228233.
Rockwood, K. et al. (2004). Prevalence, attributes, and outcomes of fitness and frailty in community-dwelling older adults: report from the Canadian study of health and aging. The Journals of Gerontology Series A: Medical Science, 59, 13101317.
Rockwood, K. et al. (2005). A global clinical measure of fitness and frailty in elderly people. Canadian Medical Association Journal, 173, 489495.
Samper-Ternent, R., Al Snih, S., Raji, M. A., Markides, K. S. and Ottenbacher, K. J. (2008). Relationship between frailty and cognitive decline in older Mexican Americans. Journal of the American Geriatrics Society, 56, 18451852.
Serviddio, G. et al. (2009). Frailty syndrome is associated with altered circulating redox balance and increased markers of oxidative stress. International Journal of Immunopathology & Pharmacology, 22, 819827.
Walston, J. et al. (2006). Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research conference on frailty in older adults. Journal of the American Geriatrics Society, 54, 9911001.
Wechsler, D. (ed.) (1997). WAIS-III Administration and Scoring Manual. New York: The Psychological Corporation.
Yogev-Seligmann, G., Hausdorff, J. M. and Giladi, N. (2008). The role of executive function and attention in gait. Movement Disorders, 23, 329342; quiz 472.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed