The journal of nutrition, health & aging

, Volume 15, Issue 9, pp 783–787 | Cite as

Definition of frailty in older men according to questionnaire data (RAND-36/SF-36): The Helsinki Businessmen study

  • J. Sirola
  • K. H. Pitkala
  • R. S. Tilvis
  • T. A. Miettinen
  • Timo E. Strandberg
JNHA: Geriatric Science



To explore the association of frailty according to questionnaire data (modified Fried criteria) with important endpoints in older men.

Design and setting

Prospective cohort study (the Helsinki Businessmen Study) in Finland.

Participants and measurements

In 1974, clinically healthy men (born 1919–1934, n=1815) of similar socioeconomic status were identified. After a 26-year follow-up in 2000 (mean age 73 years), disease prevalence, mobility-disability, and frailty status (80.9% of survivors, n=1125) were appraised using a postal questionnaire including RAND-36. Four criteria were used for definition: 1) >5% weight loss from midlife, or body mass index (BMI) <21 kg/m2; 2) reported physical inactivity; 3) low vitality (RAND-36); 4) physical weakness (RAND-36). Responders with 3–4, 1–2, and zero criteria were classified as frail (n=108), prefrail (n=567), and nonfrail (n=450), respectively. Eight-year mortality was assessed from registers, and in 2007, survivors were re-assessed with questionnaires.


Nonfrail as referent and adjusted for age, BMI and smoking, both prefrail (HR 2.26; 95% CI, 1.57–3.26), and frail status (4.09; 95% CI, 2.60–6.44) were significant predictors of mortality. Nonfrailty predicted better survival independently of the frailty components, diseases, and disability, and also predicted faster walking speed and less disability 7 years later.


Frailty, and also prefrailty, as defined using questionnaire data (RAND-36) independently predicted important endpoints in older men.

Key words

Aged frailty mortality questionnaire RAND-36 


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Copyright information

© Serdi and Springer Verlag France 2011

Authors and Affiliations

  • J. Sirola
    • 1
  • K. H. Pitkala
    • 1
  • R. S. Tilvis
    • 2
  • T. A. Miettinen
    • 2
  • Timo E. Strandberg
    • 3
    • 4
  1. 1.Helsinki University HospitalUnit of General PracticeHelsinkiFinland
  2. 2.Department of Medicine, Geriatric ClinicUniversity of HelsinkiHelsinkiFinland
  3. 3.Unit of General PracticeInstitute of Health Sciences, University of Oulu and Oulu University HospitalOuluFinland
  4. 4.Institute of Health Sciences/GeriatricsUniversity of OuluOuluFinland

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