The Definition and Diagnosis of Frailty in the Research and Clinical Settings

  • Hui-Wei Chen
  • Andres Duarte-RojoEmail author


Frailty is characterized by reduced physiological reserve and increased vulnerability to health stressors, and it is prevalent among patients with cirrhosis and particularly in those listed for liver transplantation. It is recommended to base frailty diagnosis on physical function or performance-based testing. Pending the development of consensus documents and clinical practice guidelines, multiple tools can be used to objectively assess frailty in patients with cirrhosis, including the Liver Frailty Index, gait speed testing, and the 6-minute walk test. In research settings, cardiopulmonary exercise testing is expected to provide additional information on exercise physiology. Regardless of the used tool, there is almost universal agreement on the association of frailty with worse clinical outcomes. Given the evidence linking frailty to increased healthcare costs, it is of the utmost importance to develop a model of care that includes baseline evaluation and frailty monitoring as part of the routine care of patients with cirrhosis.


Physical function Activities of daily living Deconditioning Liver Frailty Index Gait speed test Cardiopulmonary endurance Cirrhosis Liver transplantation 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Division of Gastroenterology Hepatology and NutritionUniversity of PittsburghPittsburghUSA
  2. 2.Center for Liver Diseases and Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical CenterPittsburghUSA

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