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	Deficit-Accumulation Frailty Index	Healthy Aging Index Construction
Field	Social Gerontology	Social Gerontology
Family	Process / pipeline	Process / pipeline
Year of origin	2001	2014
Originator	Arnold Mitnitski & Kenneth Rockwood	Jason L. Sanders, Anne B. Newman, and colleagues (Cardiovascular Health Study; Long Life Family Study)
Type	Continuous index of frailty as accumulated health deficits	Composite physiologic index of multisystem biological aging
Seminal source	Mitnitski, A. B., Mogilner, A. J., & Rockwood, K. (2001). Accumulation of deficits as a proxy measure of aging. The Scientific World Journal, 1, 323-336.	Sanders, J. L., Minster, R. L., Barmada, M. M., Matteini, A. M., Boudreau, R. M., Christensen, K., Walston, J. D., Newman, A. B. (2014). Heritability of and mortality prediction with a longevity phenotype: the healthy aging index. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 69(4), 479-485.
Aliases	Frailty Index, Rockwood Frailty Index, Deficit Accumulation Index, FI-CGA	HAI, Healthy Ageing Index, Multisystem Healthy Aging Index, Physiologic Aging Index
Related	4	4
Summary	The deficit-accumulation frailty index measures frailty as the proportion of a long list of age-related health deficits that a person has accumulated. Introduced by Arnold Mitnitski and Kenneth Rockwood in 2001, it treats frailty not as a fixed syndrome but as a quantitative state: the more things have gone wrong across many body systems, the frailer the person. Counting 30 or more deficits — symptoms, signs, diseases, disabilities, and laboratory abnormalities — and dividing by the number considered yields a continuous score between 0 and 1 that rises with age, predicts mortality and adverse outcomes, and behaves remarkably consistently regardless of exactly which deficits are used. A standardized procedure by Searle and colleagues made the index easy to construct from existing data.	The Healthy Aging Index (HAI) is a simple composite that summarizes the burden of subclinical physiologic decline across several organ systems into a single score. Introduced by Jason Sanders, Anne Newman, and colleagues in 2014 using the Cardiovascular Health Study, it captures the idea that biological aging is a multisystem process rather than the failure of any one organ. The index combines five readily measured markers, one from each of five physiologic systems: systolic blood pressure (vascular), fasting glucose (metabolic), Mini-Mental State Examination score (cognitive), serum creatinine (renal), and forced vital capacity (pulmonary). Each marker is scored 0, 1, or 2 according to which tertile of risk an individual falls into, and the five scores are summed to give a total from 0 to 10, with higher values indicating worse aging. The HAI predicts mortality and was shown to be heritable, supporting its interpretation as a phenotype of biological aging. Its appeal lies in being inexpensive, transparent, and built from routine clinical measurements rather than specialized assays.