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expended per week estimated in community-dwelling people over 65 years and this definition of frailty is now widely used in large epidemiological and clinical studies and formed the basis for the development of novel indexes to predict elderly people who have a higher risk of incidences of disease hospitalization falls disability and mortality We thank N van den Berg for help with the preparation of Fig 1 and N Chaturvedi and B J Zwaan for their critical reading of the manuscript LP acknowledges support from the European Research Council ERC under the European Unions Horizon 2020 research and innovation programme no 741989 and a Wellcome Trust Strategic Award JD acknowledges support from the Alexander von Humboldt Foundation We apologize to the authors of many relevant studies for not citing their work owing to space limitations Nature thanks V D Longo and J Vijg for their contribution to the peer review of this work All authors contributed to the design and writing of the Review The authors declare no competing interests