Frailty is an important factor determining a higher risk of adverse health outcomes in older adults. Although scientific community in the last two decades put a lot of effort for its definition, to date no consensus was reached on its assessment. The mainstream thinking describes frailty as a loss of physical functions or as accumulation of multiple deficits. Recently, a novel conceptual model of frailty has emerged based on the loss of harmonic interaction between multiple domains (also referred as dimensions) including genetic, biological, functional, cognitive, psychological and socio-economic domain that ultimately lead to homeostatic instability. Therefore, the multidimensional aspects of frailty condition could be captured by the comprehensive geriatric assessment (CGA) and its derived Multidimensional Prognostic Index (MPI). This instrument has been applied in different clinical settings and in several cohorts of older adults with specific acute and chronic diseases, showing always excellent accuracy in stratifying population according the mortality risk and other negative health outcomes, i.e. hospitalization, institutionalization or admission to homecare services. This MPI “plasticity” provides a single numerical prognostic index which could be helpful in clinical decision making for the management of frail older adults.

虚弱是决定老年人不良健康结果风险较高的一个重要因素。尽管近二十年来科学界为它的定义付出了很大的努力，但迄今为止对其评价尚未达成共识。主流观点将虚弱描述为身体机能的丧失或多种缺陷的累积。最近，基于多个领域（也称为维度）之间谐波相互作用的丧失，出现了一种新的脆弱概念模型，包括遗传、生物、功能、认知、心理和社会经济领域，最终导致稳态不稳定。因此，衰弱状况的多维方面可以通过综合老年评估（CGA）及其衍生的多维预后指数（MPI）来捕获。该工具已应用于不同的临床环境以及患有特定急性和慢性疾病的多个老年人群，在根据死亡风险和其他负面健康结果（即住院、住院或接受家庭护理服务）对人群进行分层方面始终表现出出色的准确性。 MPI 的“可塑性”提供了一个单一的数字预后指数，可能有助于为体弱老年人的管理做出临床决策。