Table 1.

Assessment recommendations of frailty characteristics in older adults with depression.

Clinical characteristics	Assessment measure	Notes
Overall physical function	Short Physical Performance Battery (SPPB)	A performance measure of gait speed, balance, and lower extremity strength sensitive to meaningful change.
Gait speed	18’ of straight walk way (such as a hallway or office corridor)	Measure walking speed over 15’, with extras space used to eliminate acceleration and deceleration effects; speeds ≤ 1 m/s and especially .8 m/s denote frailty level deficits.
Strength	Handgrip strength measured by JAMAR dynamometer (setting II is recommended)	The average score over typically three trials with an individual’s dominate hand (unless the dominant hand is weakened) with brief breaks in between is recommended, with handgrip strengths of ≤ 30 kg of force for men and ≤ 18 for women denoting frailty level deficits.
Activity Levels	18-item Minnesota Leisure Time Physical Activity Questionnaire.	Calculates kcal expended per week for each patient. Levels ≤ 383 kcal/week for men and 270 kcal/week for women denote frailty level deficits, but activity levels ≤ the recommended 1000 kcal/per week may denote individuals at risk for poor health outcome.
Fatigue/Fatigability	Pittsburgh Fatigability Scale	A 20-item self-report measure of physical (10-items) and mental (10- items) fatigability shown to be associated with worse physical performance and lower fitness.
	Multidimensional Fatigue Inventory	A 20-item multidimensional scale validated in cancer-related research and subsequently in the general population shown to predict poor outcome. Its assesses five dimensions of fatigue including general fatigue, mental fatigue, physical fatigue, reduced activity, and reduced motivation
Weight Loss	Probe for significant weight loss over last calendar year	Unintentional loss of 10 lbs or 5% of the previous year’s body weight denotes frailty level deficits.

Note. Assessment recommendations for clinicians to capture characteristics of frailty or characteristics similar to those identified as part of the frailty phenotype. Recommended assessments of fatigue differ from those originally recommended by Fried and colleagues to avoid the phenomenological overlap between depression and the original fatigue assessments for frailty (two energy items taken from the Center for Epidemiologic Studies-Depression Scale). Frailty cut-scores are derived from original operationalization of the frailty phenotype, averaging across different body sizes for men and women.

Abbreviations: m/s = meters per second; kg = kilograms; kcal = kilocalories; lbs = pounds.