9 They include low socioeconomic status, living alone, comorbidity, specific chronic diseases, heart failure, anemia, diabetes, depression, cognitive impairment, poor nutrition such as micronutrient deficiency, obesity, low cholesterol, and immune markers of chronic inflammation such as C-reactive protein (CRP) and interleukin-6 (IL-6).10, 11, 12, 13, 14,

15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 and 26 Few studies have simultaneously investigated diverse and overlapping risk factors together in the same participants to identify a minimal subset of unique multisystem clinical indicators of frailty risk. In this study, we developed a frailty risk Selleck DZNeP prediction tool based on simple and routine clinical measurements and externally validated it for use in primary care using data from 2 cohorts of community-living older persons. The development and validation studies

were conducted in 2 separate cohorts in the Singapore Longitudinal Ageing Studies. The first-wave cohort (SLAS-1, n = 2805) recruited residents in the southeast region of Singapore between 2003 and 2004, and followed them up Doxorubicin price at 2 years and 4 years. A second-wave cohort (SLAS-2) used identical methodologies and completed baseline survey for residents in the southwest and south central regions of Singapore from 2010 to 2013 (n = 2010 as of April 30, 2013). Previous publications have detailed the SLAS study design, population sampling, and measurements.27 The research was approved by the National University of Singapore Institutional Review Board, and informed consent was obtained from all

eltoprazine participants (response rate 78%). At baseline, all participants underwent 5 to 6 detailed interview sessions in their homes, and on-site clinical assessments, performance-based testing, and venesection by trained research personnel for an extensive range of demographic, medical, biological, psychosocial, behavioral, and neurocognitive variables. The development study was conducted in the SLAS-2 sample, and investigated 40 known and putative risk factors of phenotypic frailty, excluding correlates such as difficulties in activities of daily living (ADLs) and history of hospitalization, which are congruent outcomes of frailty. We identified 14 independent multisystem risk factors among them and derived a Frailty Risk Index (FRI). The FRI was externally validated in the SLAS-1 cohort on its ability to predict the prevalence of frailty at baseline and subsequent likelihood of functional dependency, hospitalization, and impaired quality of life at 2-year follow-up. The development study was based on baseline data of 1685 participants, after excluding participants for whom data were not available at the time for white cell counts (n = 328) and/or lymphocyte counts (n = 271).