Abstract: Aim: This study investigated whether Gordon's Functional Health Patterns (FHPs) can predict frailty in older adults residing in nursing homes over 5 years. Design: Prospective cohort study with participants from 10 nursing homes across five countries. Methods: Researchers assessed 1245 participants at baseline and 903 at follow-up (5 years) using standardised frailty measures and FHP assessments. Statistical analyses explored the relationships between FHPs and frailty. Results: FHPs, particularly those related to mobility, nutrition and social interaction, significantly predicted lower frailty risk at baseline. Furthermore, FHPs showed an increased ability to predict frailty over time, explaining a substantial portion of frailty variation at both baseline and follow-up. Analyses also revealed differences in how specific FHPs impacted frailty, suggesting the importance of individual functional variations. Conclusion: This study suggests that Gordon's FHPs are a valuable tool for predicting frailty in older adults within institutional settings. Integrating FHPs into clinical practice can promote early frailty detection and intervention. Future research should explore how FHPs change over time and their impact on frailty in broader populations.

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