Compare methods

	Healthy Aging Index Construction	Deficit-Accumulation Frailty Index
Field	Social Gerontology	Social Gerontology
Family	Process / pipeline	Process / pipeline
Year of origin	2014	2001
Originator	Jason L. Sanders, Anne B. Newman, and colleagues (Cardiovascular Health Study; Long Life Family Study)	Arnold Mitnitski & Kenneth Rockwood
Type	Composite physiologic index of multisystem biological aging	Continuous index of frailty as accumulated health deficits
Seminal source	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.	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.
Aliases	HAI, Healthy Ageing Index, Multisystem Healthy Aging Index, Physiologic Aging Index	Frailty Index, Rockwood Frailty Index, Deficit Accumulation Index, FI-CGA
Related	4	4
Summary	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.	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.