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	Deficit-Accumulation Frailty Index	Comprehensive Geriatric Assessment
Ämnesområde	Social Gerontology	Social Gerontology
Familj	Process / pipeline	Process / pipeline
Ursprungsår	2001	1993
Upphovsperson	Arnold Mitnitski & Kenneth Rockwood	Andreas E. Stuck, Laurence Z. Rubenstein and colleagues (meta-analytic synthesis)
Typ	Continuous index of frailty as accumulated health deficits	Multidimensional interdisciplinary diagnostic and care-planning process
Ursprungskälla	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.	Stuck, A. E., Siu, A. L., Wieland, G. D., Adams, J., & Rubenstein, L. Z. (1993). Comprehensive geriatric assessment: a meta-analysis of controlled trials. The Lancet, 342(8878), 1032-1036.
Alias	Frailty Index, Rockwood Frailty Index, Deficit Accumulation Index, FI-CGA	CGA, Geriatric Assessment, Multidimensional Geriatric Assessment, Interdisciplinary Geriatric Evaluation
Närliggande	4	3
Sammanfattning	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.	Comprehensive Geriatric Assessment (CGA) is a multidimensional, interdisciplinary diagnostic process that evaluates an older person's medical, functional, cognitive, psychological, social, and environmental status and translates the findings into a coordinated, monitored plan of care. Rather than treating a single presenting complaint, CGA assumes that vulnerability in late life is multifactorial and that problems in one domain spill over into others. Stuck and colleagues' landmark 1993 meta-analysis of controlled trials showed that CGA is not merely descriptive: when it includes control over the implementation of recommendations and structured follow-up, it reduces mortality, increases the chance of living at home, and improves physical and cognitive function. The same synthesis clarified that assessment alone, without the power to act on findings and to follow patients over time, yields little benefit. CGA thus reframed geriatric care around systematic, team-based evaluation linked to action. It became the organizing model for geriatric medicine units, outpatient geriatric clinics, and home-assessment programs worldwide. The method is best understood as a process, not a single scale, even though it is built from many validated instruments.