Prevalence of Frailty in Middle-aged and Older Community-dwelling Europeans Living in 10 Countries

Overview

Journal J Gerontol A Biol Sci Med Sci

Specialty Geriatrics

Date 2009 Mar 12

PMID 19276189

Citations 336

Authors

Brigitte Santos-Eggimann

Patrick Cuenoud

Jacques Spagnoli

Julien Junod

Affiliations

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Abstract

Background: Frailty is an indicator of health status in old age. Its frequency has been described mainly for North America; comparable data from other countries are lacking. Here we report on the prevalence of frailty in 10 European countries included in a population-based survey.

Methods: Cross-sectional analysis of 18,227 randomly selected community-dwelling individuals 50 years of age and older, enrolled in the Survey of Health, Aging and Retirement in Europe (SHARE) in 2004. Complete data for assessing a frailty phenotype (exhaustion, shrinking, weakness, slowness, and low physical activity) were available for 16,584 participants. Prevalences of frailty and prefrailty were estimated for individuals 50-64 years and 65 years of age and older from each country. The latter group was analyzed further after excluding disabled individuals. We estimated country effects in this subset using multivariate logistic regression models, controlling first for age, gender, and then demographics and education.

Results: The proportion of frailty (three to five criteria) or prefrailty (one to two criteria) was higher in southern than in northern Europe. International differences in the prevalences of frailty and prefrailty for 65 years and older group persisted after excluding the disabled. Demographic characteristics did not account for international differences; however, education was associated with frailty. Controlling for education, age and gender diminished the effects of residing in Italy and Spain.

Conclusions: A higher prevalence of frailty in southern countries is consistent with previous findings of a north-south gradient for other health indicators in SHARE. Our data suggest that socioeconomic factors like education contribute to these differences in frailty and prefrailty.

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References

Walston J, Hadley E, Ferrucci L, Guralnik J, Newman A, Studenski S . Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. J Am Geriatr Soc. 2006; 54(6):991-1001. DOI: 10.1111/j.1532-5415.2006.00745.x. View

Fried L, Ferrucci L, Darer J, Williamson J, Anderson G . Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004; 59(3):255-63. DOI: 10.1093/gerona/59.3.m255. View

BORTZ 2nd W . The physics of frailty. J Am Geriatr Soc. 1993; 41(9):1004-8. View

Buchner D, Wagner E . Preventing frail health. Clin Geriatr Med. 1992; 8(1):1-17. View

Bandeen-Roche K, Xue Q, Ferrucci L, Walston J, Guralnik J, Chaves P . Phenotype of frailty: characterization in the women's health and aging studies. J Gerontol A Biol Sci Med Sci. 2006; 61(3):262-6. DOI: 10.1093/gerona/61.3.262. View

Woods N, LaCroix A, Gray S, Aragaki A, Cochrane B, Brunner R . Frailty: emergence and consequences in women aged 65 and older in the Women's Health Initiative Observational Study. J Am Geriatr Soc. 2005; 53(8):1321-30. DOI: 10.1111/j.1532-5415.2005.53405.x. View

Cesari M, Leeuwenburgh C, Lauretani F, Onder G, Bandinelli S, Maraldi C . Frailty syndrome and skeletal muscle: results from the Invecchiare in Chianti study. Am J Clin Nutr. 2006; 83(5):1142-8. PMC: 2668161. DOI: 10.1093/ajcn/83.5.1142. View

Ensrud K, Ewing S, Taylor B, Fink H, Stone K, Cauley J . Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci. 2007; 62(7):744-51. DOI: 10.1093/gerona/62.7.744. View

Mohr B, Bhasin S, Kupelian V, Araujo A, ODonnell A, McKinlay J . Testosterone, sex hormone-binding globulin, and frailty in older men. J Am Geriatr Soc. 2007; 55(4):548-55. DOI: 10.1111/j.1532-5415.2007.01121.x. View

10.

Ensrud K, Ewing S, Taylor B, Fink H, Cawthon P, Stone K . Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Arch Intern Med. 2008; 168(4):382-9. DOI: 10.1001/archinternmed.2007.113. View

11.

Fried L, Tangen C, Walston J, Newman A, Hirsch C, Gottdiener J . Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001; 56(3):M146-56. DOI: 10.1093/gerona/56.3.m146. View

12.

Cawthon P, Marshall L, Michael Y, Dam T, Ensrud K, Barrett-Connor E . Frailty in older men: prevalence, progression, and relationship with mortality. J Am Geriatr Soc. 2007; 55(8):1216-23. DOI: 10.1111/j.1532-5415.2007.01259.x. View

13.

Gill T, Gahbauer E, Allore H, Han L . Transitions between frailty states among community-living older persons. Arch Intern Med. 2006; 166(4):418-23. DOI: 10.1001/archinte.166.4.418. View

14.

Vellas B, Gillette-Guyonnet S, Nourhashemi F, Rolland Y, Lauque S, Ousset P . [Falls, frailty and osteoporosis in the elderly: a public health problem]. Rev Med Interne. 2000; 21(7):608-13. DOI: 10.1016/s0248-8663(00)80006-5. View

15.

Ottenbacher K, Ostir G, Peek M, Al Snih S, Raji M, Markides K . Frailty in older Mexican Americans. J Am Geriatr Soc. 2005; 53(9):1524-31. PMC: 1388072. DOI: 10.1111/j.1532-5415.2005.53511.x. View

16.

Puts M, Lips P, Deeg D . Sex differences in the risk of frailty for mortality independent of disability and chronic diseases. J Am Geriatr Soc. 2005; 53(1):40-7. DOI: 10.1111/j.1532-5415.2005.53008.x. View

17.

Hogan D, MacKnight C, Bergman H . Models, definitions, and criteria of frailty. Aging Clin Exp Res. 2003; 15(3 Suppl):1-29. View