The Association Between Neighborhood Disadvantage and Frailty: A Retrospective Case Series

Overview

Journal J Public Health Res

Publisher Sage Publications

Specialty Public Health

Date 2024 Jun 13

PMID 38867913

Authors

David Fenton

Amani Allen

Johnathan R Kent

Rachel Nordgren

Allison Liu

Nihar Rama

Ally Wang

Daniel Rubin

Lauren J Gleason

A Justine Landi

Megan Huisingh-Scheetz

Mark K Ferguson

Maria Lucia L Madariaga

Affiliations

Soon will be listed here.

Abstract

Background: Frailty predicts poorer outcomes in surgical patients. Recent studies have found socioeconomic status to be an important characteristic for surgical outcomes. We evaluated the association of Area Deprivation Index (ADI) and Social Vulnerability Index (SVI), two geospatial atlases that provide a multidimensional evaluation of neighborhood deprivation, with frailty in a surgery population.

Design & Methods: A retrospective study of patients undergoing routine frailty screening was conducted 12/2020-8/2022. Frailty was measured using Fried's Frailty Phenotype (FFP) and the five-item Modified Frailty Index (mFI-5). ADI and SVI quartiles were determined using patient residence. Logistic regression models were used to evaluated associations of FFP (frail only vs not frail) and mFI-5 (≥2 vs 0-1) with ADI and SVI (α = 0.05).

Results: Of 372 screened patients, 41% (154) were women, median age was 68% (63-74), and 46% (170) identified as non-White. Across ADI and SVI quartiles, higher number of comorbidities, decreasing median income, and frailty were associated with increasing deprivation ( < 0.01). When controlling for age, sex, comorbidities, and BMI category, frailty by FFP was associated with the most deprived two quartiles of ADI (OR 2.61, CI: [1.35-5.03], < 0.01) and the most deprived quartile of SVI (OR 2.33, [1.10-4.95], < 0.05). These trends were also seen with mFI-5 scores ≥2 (ADI: OR 1.64, [1.02-2.63], < 0.05; SVI: OR 1.71, [1.01-2.91], < 0.05).

Conclusions: Surgical patients living in socioeconomically deprived neighborhoods are more likely to be frail. Interventions may include screening of disadvantaged populations and resource allocation to vulnerable neighborhoods.

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