This study aimed to determine the effects of Tilburg Frailty Indicator (TFI) and frailty phenotype (FP) in senile inpatients with frailty and provide a reference for the clinical evaluation of debilitating elderly patients. The effect of silver nanoparticle (AgNP)-silver needle acupuncture was also evaluated. Overall, 48 elderly inpatients with an average age of 69.5±6.2 years were included in the study. The results of two weakness assessment methods in screening the same elderly population were compared, and the correlation or consistency between the two methods was analyzed. A AgNPsilver needle was used for acupuncture treatment. The TFI score ranged from 0 to 12, with an average score of 4.0±0.7 (frailty [TFI>5] in 22 elderly patients [45.8%] and non-frailty in 26 patients [54.2%]). FP was presented in different stages, and the FP score ranged from 0 to 5, with an average score of 2.1±1.4, including non-frailty in 12 (25%) patients and pre-frailty in 19 (39.6%) patients. Moreover, 17 patients (35.4%) were debilitated. The two assessment methods showed that the degree of debilitation increased with advancing age in the elderly. The TFI score was positively associated with the defined stage of FP (r = 0.911, P <0.001). The consistency of TFI grading with phenotypic definition kappa value was 0.786 (P <0.001), and the area under the curve was 0.872 (95% confidence interval, 0.834-1.000; P <0.05). After acupuncture and moxibustion, the patient's condition evidently improved. In this study, the proportion of non-debilitating elderly hospitalized patients was higher than that of debilitating elderly hospitalized patients, and the degree of debilitating increased with advancing age. The TFI score was positively associated with the stage of phenotypic definition, and TFI frailty assessment was highly sensitive. Both methods had screening value, but TFI was more effective in screening patients with pre-frailty than FP, resulting in the early intervention and treatment of debilitating elderly hospitalized patients. A silver needle acupuncture can be used for treating senile frailty, providing a new idea for the clinical treatment of frailty.