This study investigates frailty, defined as the accumulation of deficits in physiological functioning, by applying the Skeletal Frailty Index (SFI) to a skeletal sample (N=67) recovered from the Mississippi State Asylum (MSA), and in a comparative sample, the Terry Collection. The SFI was statistically modified to increase its utility here. Variables that influence frailty, including age, sex, stress in early-life, and resilience, were assessed relative to four SFIs: Overall, Nutritional, Activity, and Infection. This study finds that the predicted relationships between the SFIs and the aforementioned variables are largely absent in the MSA sample. When compared to individuals in the Terry, MSA individuals generally manifest a lower prevalence of biomarkers but have reduced longevity, which suggests that MSA patients experienced higher frailty and lower resilience. This may be attributable to negative biosocial experiences over the life course prior to institutionalization, but primarily to often-negative environmental conditions during institutionalization.