*Purpose: We proposed to evaluate physical frailty in lung transplant candidates to determine whether physical frailty correlated with LAS score and added to ability to predict patient outcomes including death on the waiting list.

*Methods: In this single-center prospective study, frailty was assessed in lung transplant candidates ≥ 60 years of age using Fried’s Frailty Phenotype (FFP) and the Short Physical Performance Battery (SPPB). The FFP score is based on self-reported weight loss, fatigue, and physical activity, and measures of gait speed and grip strength. The SPPB score consists of measures of gait speed, balance, and lower extremity strength. Using previously established cutoffs, an FFP score of 0 = non-frail; 1-2 = pre-frail; and 3-5 = frail, while an SPPB score of 0-6 = frail; 7-9 = pre-frail; and 10-12 = non-frail.

*Results: Out of 44 subjects, 38 completed both SPPB and FFP assessments, while 6 completed only SPPB assessments. The median SPPB and FFP scores were 8 and 3 respectively (Figure 1). By SPPB criteria 34% of subjects are frail, 41% are pre-frail, and 25% are non-frail. By FFP criteria, 55.3% are frail, 39.4% are pre-frail, and 5.2% are non-frail (Figure 2). The average LAS score is 44.2 (±14.2). Both the SPPB (r²=0.19, p = 0.01) and FFP (r²=0.33, p<0.01) are correlated with LAS score. 6 patients died on the waiting list. 16 candidates underwent transplantation.

*Conclusions: Although both physical frailty assessments correlated with LAS score, the FFP score is more strongly correlated. The SPPB and FFP assessments differed, resulting in discordant predictions of the prevalence of frailty in lung transplant candidates. Ongoing studies will determine whether SPPB data can add to the predictive value of LAS in terms of death on the waiting list and post-transplant outcomes for the growing numbers of older lung transplant candidates.

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