Experimental Section / Mini-Review
Gerontology
Frailty Assessment in Animal Models
Stefan D. Heinze-Milne
a
Shubham Banga
a
Susan E. Howlett
a, b
a
Department of Pharmacology, Dalhousie University, Halifax, NS, Canada;
b
Department of Medicine (Geriatric
Medicine), Dalhousie University, Halifax, NS, Canada
Received: April 8, 2019
Accepted after revision: June 5, 2019
Published online: July 22, 2019
Susan E. Howlett, PhD
Department of Pharmacology, Dalhousie University
5850 College St., PO Box 15000
Halifax, NS B3H 4R2 (Canada)
E-Mail susan.howlett @dal.ca
© 2019 S. Karger AG, Basel
E-Mail karger@karger.com
www.karger.com/ger
DOI: 10.1159/000501333
Keywords
Aging · Animal models · Frailty · Frailty index · Frailty
phenotype · Health span
Abstract
Although frailty has been extensively investigated for the
last 2 decades, preclinical models of frailty have only been
developed over the past decade. Frailty is a concept that
helps to explain the difference between chronologic age
and biologic age and to discuss health span along with lifes-
pan. In general, a frail individual will be more susceptible to
adverse health outcomes than a healthy, nonfrail individual
of the same age. However, the biology and mechanisms of
frailty are still unclear. The development of preclinical mod-
els of frailty and frailty assessment tools are invaluable to
geriatric research. This review briefly describes the concept
of frailty and discusses the newly developed animal models
of frailty, specifically the frailty phenotype- and frailty index-
based models. Mouse models are the most common models
for preclinical frailty research, but rat and canine models for
frailty assessment have also been developed. These models
can facilitate the testing of frailty-specific treatments and
help to investigate the effects of various interventions on
frailty. Similarities and differences between human and ani-
mal models, including sex differences in frailty, are also dis-
cussed. The availability of animal models of frailty is a valu-
able and welcome addition to the study of frailty, aging, or
the disorders of old age and will enable a better understand-
ing of frailty mechanisms. © 2019 S. Karger AG, Basel
Introduction to Frailty
How and why people “age” at different rates continues
to elude us. It has long been known that people and ani-
mals develop health deficits at different rates as they age.
Some individuals simply become frail faster than others,
although the reasons for this are not well understood and
may involve several mechanisms. In recent years, the in-
terest in understanding and quantifying frailty has grown.
This is, in part, due to the aging population in many de-
veloped countries. The prevalence of frail older people
increases with age (i.e., >80 years) around the globe [1].
This is problematic for healthcare since frail individuals
are at an increased risk of morbidity/mortality [2]. Frailty
has no internationally accepted definition; however, it
has been defined as an increased susceptibility to adverse
health outcomes [3]. It is associated with age and disease,
although neither is necessary for frailty to occur [4]. The
biology of frailty is not yet well understood, although pro-
posed mechanisms include increased oxidative stress,
DNA repair malfunction, chronic inflammation, cellular
senescence, endocrine dysfunction, and mitochondrial
damage [4, 5]. Overall it is thought that frailty lowers
physiologic reserves, which predisposes a frail person to
a worse reaction to health challenges than a nonfrail per-
son.
Frailty has been studied in humans increasingly since
the early 2000s. The breakthrough into studying frailty as
a clinical condition was the development of tools to quan-
tify frailty. The 2 dominant methods to measure frailty in