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Frailty reflects a gradual loss of physiologic reserve that increases risk for falls, hospitalization, and mortality in older adults. While it can be measured in different ways, there is ongoing uncertainty around how well commonly used approaches capture real-world function. The VA Frailty Index (VAFI) is a widely used, claims-based measure that summarizes accumulated health deficits, but it does not directly assess how someone is functioning day to day. In contrast, physical performance measures such as gait speed, grip strength, and chair stands provide a more immediate and objective view of functional status.

This project explores how frailty, measured by VAFI, relates to objective physical performance in older Veterans participating in Gerofit, a supervised exercise program at the West Los Angeles VA that collects repeated functional data over time. By linking electronic health record data with longitudinal physical performance measures, we aim to better understand whether changes in physical function are reflected in changes in frailty scores.

We expect that improvements in physical performance will be associated with reductions in VAFI scores, though these changes may not occur in parallel. VAFI may be slower to reflect short-term functional gains, and certain measures, particularly gait speed, may align more closely with frailty changes than others. It is also possible that frailty scores plateau over time despite continued improvements in physical performance, suggesting limits in how sensitive chart-based measures are to functional change.

Overall, this work aims to clarify how a commonly used frailty measure relates to real-world function and to generate more clinically meaningful insights for the care of older adults. By better understanding this relationship, clinicians may be able to interpret frailty scores more thoughtfully and tailor interventions to support functional independence in aging Veterans.