Social and behavioural factors associated with frailty trajectories in a population-based cohort of older adults

Abstract

ObjectiveThe goal of this study was to identify distinct frailty trajectories (clusters of individuals following a similar progression of frailty over time) in an ageing population and to determine social and behavioural factors associated with frailty trajectories.DesignPopulation-based cohort study.SettingOlmsted County, Minnesota.ParticipantsOlmsted County, Minnesota residents aged 60–89 in 2005.Primary outcome measureChanges in frailty over an 8-year period from 2005 to 2012, measured by constructing a yearly frailty index. Frailty trajectories by decade of age were determined using k-means cluster modelling for longitudinal data.ResultsAfter adjustment for age and sex, all social and behavioural factors (education, marital status, living arrangements, smoking status and alcohol use) were significantly associated with frailty trajectories in those aged 60–69 and 70–79 years. After further adjustment for baseline frailty, the likelihood of being in the high frailty trajectory was greatest among those reporting concerns from relatives/friends about alcohol consumption (OR (95% CI) 2.26 (1.19 to 4.29)) and those with less than a high school education (OR (95% CI) 1.98 (1.32 to 2.96)) in the 60–69 year olds. In the 70–79 year olds, the largest associations were observed among those with concerns from oneself about alcohol consumption (OR (95% CI) 1.92 (1.23 to 3.00)), those with less than a high school education (OR (95% CI) 1.57 (1.12 to 2.22)), and those living with family (vs spouse; OR (95% CI) 1.76 (1.05 to 2.94)). No factors remained associated with frailty trajectories in the 80–89 year olds after adjustment for baseline frailty.ConclusionsSocial and behavioural factors are associated with frailty, with stronger associations observed in younger ages. Recognition of social and behavioural factors associated with increasing frailty may inform interventions for individuals at risk of worsening frailty, specifically when targeted at younger individuals.

Frailty index and its associations with self‐neglect, social support and sociodemographic characteristics among older adults in rural China

“…Interestingly, the associations between education, income and frailty disappeared in the group of aged ≥77 years. The age difference was also found in a population‐based cohort of older adults from the USA . It is also surprising that smoking and alcohol consumption have inverse associations with frailty, which was also found in previous studies .…”

“…Sociodemographic characteristics are also important for frailty. For example, sex, education, marriage status, income, smoking and alcohol drinking were reported to be associated with frailty in previous studies . However, such research findings were inconsistent with different published works, with education, smoking and alcohol drinking not being associated with frailty in some studies .…”

Telomere shortening and frailty in Mexican older adults

“…Tobacco consumption was a determining factor for the present study's sample, and it explains the environmental association through an OR of 2.72 (95% CI 1.13–6.53; data not shown), an opposite result from the study of the Dutch population (OR 0.73, 95% CI 0.43–1.03), but similar to that which was reported in the USA (OR 3.31, 95% CI 1.33–8.27) . Tobacco consumption is highly harmful for general health, due to the great number of chemicals and traces of highly reactive compounds that when assimilated into an organism can generate inflammatory processes, by which reactive oxygen species are released, which in turn generates oxidative stress, affecting telomere shortening .…”

Association between oral health and frailty: A systematic review of longitudinal studies

“…An important factor that could explain this association is the role of socio‐economic factors in both frailty and oral health. Previous studies found that older adults with less education were more frail compared to those with better education . This was also observed when neighbourhood socio‐economic characteristics were used .…”