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Thomas Horton


  • Syndrome of physiological decline in late life, characterized by marked vulnerability to adverse health outcomes


  • FRAIL Scale Identifies frailty in community dwelling elders (1 -2 = prefrail; > 3 = frail)
    • Fatigue: are you Fatigued more often than not?
    • Resistance: are you able to climb a flight of stairs?
    • Aerobic: are you bale to walk a block?
    • Illness: Do you have more than five illnesses?
    • Loss: Have you lost more than 5% of weight in 6 months?
  • Order Vitamin D and B-12 Levels.


  • Adapt interventions to the individual, incorporating patient preferences and stage on the spectrum of frailty
  • Exercise programs with additional physical and occupational therapy input if indicated.
  • Optimize nutrition via supplementation (Vit D, B12)
  • Comprehensive Geriatric Assessment; Outpatient PACE