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J Affect Disord. 2020 May 1;268:183-187. doi: 10.1016/j.jad.2020.03.015. Epub 2020 Mar 6.

Frailty Index as a clinical measure of biological age in psychiatry.

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Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy. Electronic address:
Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy.
Fondazione IRCCS Ca, Granda Ospedale Maggiore Policlinico, Milan, Italy; Geriatric Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
Department of Psychiatry, University of California San Francisco, San Francisco, USA.



Serious mental illnesses may be characterized by accelerated biological aging, and over the last years the research on the topic has been stimulated by studies exploring the molecular underpinnings of senescence.


In the present manuscript we propose that measuring frailty, a general product of organismal ageing, through the "Frailty Index" (FI), a recently-emerged macroscopic indicator of functional status and biological age, adds an important marker to the measurements currently implemented in the study of accelerated biological age in psychiatric illnesses.


The FI quantifies functional negative health attributes and measures their cumulative effect, thus providing a useful estimate of the individual's biological age and risk profile. Recent studies in older adults have observed significant associations between FI and molecular measures of aging.


High FI values can be driven by causes different from aging per se, so FI may be a sensitive but not specific measure of biological aging.


FI, which is extensively used in geriatrics and gerontology but it has rarely been used in relation to mental health, may be of relevance in the evaluation of age-related phenomena associated with psychiatric diseases.


Biological Ageing; Frailty Index; Mental Health; Premature Senescence


Conflict of interest statement

Declaration of Competing Interest All authors have no actual or past potential conflict of interest to disclose, including any financial, personal or other relationships with other people or organizations that could inappropriately have influenced the results presented in this paper.

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