Table 3.

Maximizing strengths and avoiding weaknesses of human gerontology frailty assessment in a proposed companion dog frailty instrument.

Strengths
Human frailty assessment	Proposal
Several key phenotypic factors (unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, poor endurance, and low physical activity) are included in the most commonly used instruments (15, 39, 41, 56, 86–91).	Adapt these key dimensions to dogs
Instruments that include multiple physiologic domains such as illness or comorbidities, functional status for daily activities, use of medications, decreased appetite, nutrition, balance, flexibility, falls, mobility disability, and vision loss (1, 23, 29, 30, 34, 37, 40, 41, 55, 87, 89, 90, 92–94).	Include assessments of physiologic domains relevant to dogs to broaden the assessment
Instruments that include multiple functional (non-medical) domains such as activities of daily living (ADL)/instrumental activities of daily living (IADL), communication (speech/hearing), mood alteration, low motivation, reclusion, cognition, and social support (1, 23, 28–31, 34, 41, 55, 92)	Include assessments of functional domains relevant to dogs to broaden the assessment
Multidimensional instruments (31, 36, 95).	Ensure multi-dimensional components are included to maximize predictive value
Short instruments (15, 39, 87).	Minimize the number of components to decrease the burden on users
Instruments utilizing self-reporting (29, 89, 92).	Select components apparent to dog owners at home
Assessment that can be performed at home, by phone or mail (35, 91–93).	Select components readily assessed by dog owners at home
Instruments that can be performed by individuals without medical training (31, 32, 88).	Select components that can be performed by owners
Instruments that can be performed by primary care providers (29).	Select components that can quickly be performed by veterinary general practitioner
Weaknesses
Human frailty assessment	Proposal
Lengthy/time-consuming instruments (28, 96, 97).	Ensure that owner or primary care veterinarian can complete in less than 30 min to minimize burden on users
Instruments that include complex measurements including the Progressive Romberg Test, Brachial Ankle Index, and tests using wireless motion sensors (56, 98).	Limit to simple, low-tech measurements to facilitate wide use
Instruments that include medical or laboratory data (albumin, blood pressure – systolic or arterial, red blood cells/hemoglobin counts, etc.) which may be unavailable or expensive to acquire (23, 28, 34, 37, 55, 56, 99).	Limit to externally apparent phenotypic data to avoid invasiveness or added cost
Instruments that require specifically trained personnel to administer (17).	Ensure that minimally trained owners or veterinary personnel can obtain each measurement to facilitate wide use