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J Epidemiol Community Health. 2017 Aug;71(8):794-799. doi: 10.1136/jech-2016-208853. Epub 2017 Jul 5.

Assessing the measurement properties of a Frailty Index across the age spectrum in the Canadian Longitudinal Study on Aging.

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Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
McMaster Institute for Research on Aging, Hamilton, Canada.
Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Canada.
Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.
School of Rehabilitation Science, McMaster University, Hamilton, Canada.
Division of Geriatric Medicine, Department of Medicine, McMaster University, Hamilton, Canada.



Frailty is a way to appreciate the variable vulnerability to declining health status of people as they age. No consensus for measuring frailty has been established. This study aimed to adapt a Frailty Index (FI) to the Canadian Longitudinal Study on Aging (CLSA) and evaluate its applicability in both younger and older adults.


An FI was created based on 90 potential health deficits collected from adults aged 45-85 years at recruitment (N=21 241, 49.0% male). The construct validity of this instrument and the factor structure of the health deficits were evaluated.


The direction of associations between the FI and other variables were consistent with a priori hypotheses for construct validity. FI values were significantly associated with age (r=0.17; p<0.001), falls (r=0.12; p<0.001), injuries (r=0.12; p<0.001), formal home care (r =0.30; p<0.001), informal home care (r=0.32; p<0.001) and use of assistive devices (r=0.40; p<0.001). Values were negatively associated with male sex (r=-0.12; p<0.001), income (r=-0.34; p<0.001) and education (r=-0.17; p<0.001). Key factors among the health indicators were physical functioning, satisfaction with life and depressive symptoms. Results did not change when the sample was stratified by age and sex.


The FI is a feasible method to evaluate frailty and capture frailty-related heterogeneity in populations aged 45-85 years. In this study, the FI had good construct validity in middle-aged and older adults, showing expected correlations with sociodemographic factors consistently across age groups. This method can be easily reproduced in similar datasets, making the FI a generalisable instrument.


Ageing; CLSA; Epidemiology of ageing; Measurement tool development

[Indexed for MEDLINE]

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