Which of the following is NOT a hallmark of frailty?

• A. Sarcopenia
• B. Unintentional weight loss (10 lbs in 1 year)
• C. Self-reported exhaustion
• D. Obesity

Answer: (D)

Frailty reflects reduced physiologic reserve and increased vulnerability to stressors. The commonly used frailty model identifies five hallmarks: unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity. Sarcopenia, the loss of muscle mass and strength, is a key contributor to weakness and slowness and thus sits squarely with frailty. Obesity, while common in older adults, does not by itself define frailty and can even coexist with frailty or mask it in some cases (sarcopenic obesity). Therefore obesity is not a hallmark of frailty.