Aging as a process of deficit accumulation: its utility and origin.

Individuals of the same age differ greatly with respect to their health status and life span. We have suggested that the health status of individuals can be represented by the number of health deficits that they accumulate during their life. We have suggested that this can be measured by a fitness-frailty index (or just a frailty index), which is the ratio of the deficits present in a person to the total number of deficits considered (e.g. available in a given database or experimental procedure). Further, we have proposed that the frailty index represents the biological age of the individual, and suggested an algorithm for its estimation. In investigations by many groups, the frailty index has shown reproducible properties such as: age-specific, nonlinear increase, higher values in women, strong association with mortality and other adverse outcomes, and universal limit to its increase. At the level of individual, the frailty index shows complex stochastic dynamics, reflecting both stochasticity of the environment and the ability to recover from various illnesses. Most recently, we have proposed that the origin of deficit accumulation lies in the interaction between the environment, the organism and its ability to recover. We apply a stochastic dynamics framework to illustrate that the average recovery time increases with age, mimicking the age-associated increase in deficit accumulation.