Table 1.
Definitions of frailty adapted from the Cardiovascular Health Study definition
| Components of Frailty | USRDS DMMS Wave 2 (Incident Dialysis)6 | CDS (Incident Dialysis)7 | REXDP (Prevalent Hemodialysis)8 | NHANES (CKD)9 | Seattle Kidney Study (CKD Stages 1–4)28 |
|---|---|---|---|---|---|
| Slowness/weakness | Rand-36 Physical Function Scale score<75 | SF-12 Physical Function score<75 | Slowness: gait speed over 6 m using cutpoints that correspond to the same speed as the cutpoints from the 15-ft walk in the CHS | Slowness: gait speed over 8 ft with lowest quintile adjusted for sex | Slowness: walking pace assessed over a 4-m course using cutpoints that correspond to the same speed as the cutpoints from the 15-ft walk in the CHS |
| The following items are about activities that you might do during a typical day: does your health now limit you in these activities? If so, how much? | Weakness: patients were asked to stand up and sit down five times; the time for the slowest quartile of the SPPB chair stand based on community-dwelling elderly cohorts was used to define frailty | Weakness: based on self-report and defined as present if participants answered some difficulty, much difficulty, or unable to do when asked how much difficulty they have lifting or carrying something as heavy as 10 lbs (like a sack of potatoes or rice) | Weakness: Grip strength using the same absolute cutoffs as in the CHS | ||
| Vigorous activities, such as running, lifting heavy objects, or participating in strenuous sports | |||||
| Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf | |||||
| Lifting or carrying groceries | |||||
| Climbing several flights of stairs | |||||
| Climbing one flight of stairs | |||||
| Bending, kneeling, or stooping | |||||
| Walking more than 1 mi | |||||
| Walking several blocks | |||||
| Walking 1 block | |||||
| Bathing or dressing yourself | |||||
| Poor endurance/exhaustion | Rand-36 Vitality Scale score<55 | SF-12 Vitality score<55 | SF-36 Vitality score<55 | Defined as present if participants answered some difficulty, much difficulty, or unable to do when asked how much difficulty they have walking from one room to the other on the same level | SF-36 Vitality score<37.5 |
| How much of the time during the last 30 days? | |||||
| Did you feel worn out? | |||||
| Did you feel tired? | |||||
| Did you have a lot of energy? | |||||
| Did you feel full of pep? | |||||
| Physical inactivity | How often do you exercise (do physical activity during your leisure time)? | Lowest quintile based on age- and sex-specific population norms for the Human Activity Profile | Patients who reported no activity beyond self-care and activities required for living were considered inactive | Compared with most (men/women) your age, would you say that you are more active, less active, or about the same? | Self-reported exercise less than one time per week |
| Daily or almost daily | Patients answering less active were classified as inactive | ||||
| Four to five times a week | |||||
| Two to three times a week | |||||
| About one time a week | |||||
| Less than one time a week | |||||
| Almost never or never | |||||
| Patients answering almost never or never were classified as inactive | |||||
| Unintentional weight loss or shrinkage | Undernourished or cachectic (malnourished) as assessed by data abstractor | Not included | BMI≤18.5 kg/m2 | BMI≤18.5 kg/m2 | Self-reported ≥10-lb unintentional weight loss in past 6 months |
See ref2 for Cardiovascular Health Study. USRDS, US Renal Data System; DMMS, Dialysis Morbidity and Mortality Study; CDS, Comprehensive Dialysis Study; REXDP, Renal Exercise Demonstration Project; NHANES, National Health and Nutrition Examination Survey; CHS, Cardiovascular Health Study; SPPB, short physical performance battery.