Social and Economic Predictors of Worse Frailty Status Occurrence Across Selected Countries in North and South America and Europe

Gomes, Camila de Carvalho; Guerra, Ricardo Oliveira; Wu, Yan Yan; Fernandes, Juliana; Gómez, Fernando; Sousa, Ana Carolina Patrício de Albuquerque; Pirkle, Catherine M

doi:10.1093/geroni/igy037

Cited by 18 publications

(15 citation statements)

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“…To estimate the global incidence of frailty, data were included from 46 studies. 41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,83,84,85,86 Among people without frailty at baseline who survived a median follow-up of 3.0 (range, 1.0-11.7) years, 13.6% (13 678 of 100 313) became frail. The pooled incidence rate of frailty was 43.4 (95% CI, 37.3-50.4; I 2 = 98.5%) cases per 1000 person-years (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-one studies 41,42,46,51,53,57,59,60,65,66,67,68,69,71,72,77,79,80,81,82,83 reported data on the global incidence of prefrailty among 32 268 community-dwelling older adults who were robust at baseline and survived a median follow-up of 2.5 (range, 1.0-10.0) years. During the follow-up, 30.9% (9974 of 32 268) became prefrail.…”

Section: Resultsmentioning

confidence: 99%

“…We found a higher incidence of frailty and prefrailty in LMICs than HICs in our study, which is consistent with prior observations of significantly higher prevalence of frailty and prefrailty in LMICs compared with HICs. 99 Some studies 59,87,100 found that high income and educational levels and greater access to and quality of health care confer lower frailty risk, which may partly explain the disparity in frailty incidence between LMICs and HICs, presenting opportunity to prevent or delay the onset of chronic pathologies associated with increased risk of frailty. 88,101…”

Section: Discussionmentioning

confidence: 99%

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Global Incidence of Frailty and Prefrailty Among Community-Dwelling Older Adults

et al. 2019

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IMPORTANCE Frailty is a common geriatric syndrome of significant public health importance, yet there is limited understanding of the risk of frailty development at a population level. OBJECTIVE To estimate the global incidence of frailty and prefrailty among community-dwelling adults 60 years or older.DATA SOURCES MEDLINE, Embase, PsycINFO, Web of Science, CINAHL Plus, and AMED (Allied and Complementary Medicine Database) were searched from inception to January 2019 without language restrictions using combinations of the keywords frailty, older adults, and incidence. The reference lists of eligible studies were hand searched. STUDY SELECTIONIn the systematic review, 2 authors undertook the search, article screening, and study selection. Cohort studies that reported or had sufficient data to compute incidence of frailty or prefrailty among community-dwelling adults 60 years or older at baseline were eligible. DATA EXTRACTION AND SYNTHESISThe methodological quality of included studies was assessed using The Joanna Briggs Institute's Critical Appraisal Checklist for Prevalence and Incidence Studies.Meta-analysis was conducted using a random-effects (DerSimonian and Laird) model. MAIN OUTCOMES AND MEASURESIncidence of frailty (defined as new cases of frailty among robust or prefrail individuals) and incidence of prefrailty (defined as new cases of prefrailty among robust individuals), both over a specified duration. RESULTSOf 15 176 retrieved references, 46 observational studies involving 120 805 nonfrail (robust or prefrail) participants from 28 countries were included in this systematic review. Among the nonfrail individuals who survived a median follow-up of 3.0 (range, 1.0-11.7) years, 13.6% (13 678 of 100 313) became frail, with the pooled incidence rate being 43.4 (95% CI, 37.3-50.4; I 2 = 98.5%) cases per 1000 person-years. The incidence of frailty was significantly higher in prefrail individuals than robust individuals (pooled incidence rates, 62.7 [95% CI, 49.2-79.8; I 2 = 97.8%] vs 12.0 [95% CI, 8.2-17.5; I 2 = 94.9%] cases per 1000 person-years, respectively; P for difference < .001). Among robust individuals in 21 studies who survived a median follow-up of 2.5 (range, 1.0-10.0) years, 30.9% (9974 of 32 268) became prefrail, with the pooled incidence rate being 150.6 (95% CI, 123.3-184.1; I 2 = 98.9%) cases per 1000 person-years. The frailty and prefrailty incidence rates were significantly higher in women than men (frailty: 44.8 [95% CI, 36.7-61.3; I 2 = 97.9%] vs 24.3 [95% CI, 19.6-30.1; I 2 = 8.94%] cases per 1000 person-years; prefrailty: 173.2 [95% CI, 87.9-341.2; I 2 = 99.1%] vs 129.0 (continued) Key PointsQuestion What is the incidence of frailty and prefrailty among communitydwelling adults 60 years or older?Findings In this systematic review and meta-analysis involving data from more than 120 000 older adults from 28 countries, the incidence of frailty and prefrailty was estimated as 43.4 and 150.6 new cases per 1000 person-years, respectively. The frailty and prefrailty incidence rates varied by ...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Global Incidence of Frailty and Prefrailty Among Community-Dwelling Older Adults

et al. 2019

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“…Socioeconomic factors have been known to contribute to frailty, and frailty prevalence itself is higher in LMICs than in higher-income countries [39,65], but the causal directionality remains unclear. Worsening of physical strength may lessen the ability to work and heighten risk of economic difficulties, which may lead to inability to pay for health insurance and poor nutritional intake, leading to frailty [39,65]. This study, however, did not show any correlation between family income and frailty.…”

Section: Prevalence Of Frailty and Associated Factorsmentioning

confidence: 99%

Frailty among HIV-1 Infected Adults under Antiretroviral Therapy in Indonesia

Wulunggono

Yunihastuti

Shatri

et al. 2019

CHR

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Background: Increasing age of HIV-1 infected population brought about the risk of frailty as comorbidity, whose prevalence is higher in low and middle-income countries (LMICs). Indonesia as an LMIC also bears a major burden of HIV-1 epidemic with a similarly aging population, but the prevalence of frailty and its predictors are unknown. Objectives: To identify the prevalence of frailty and analyze its associated factors, among HIV-1 infected adults under antiretroviral therapy in Indonesia. Methods: A cross-sectional study was conducted among HIV-infected individuals with inclusion criteria of age ≥30 years old and underwent ART for at least 6 months. The main assessment was done using Fried’s frailty phenotype score, which categorizes subjects into non-frail, pre-frail, or frail. Factors associated with frailty were characterized and multiple logistic regression analysis was performed. Results: A total of 164 subjects were recruited; male subjects were 118 (72%), the median age was 40.5 years old, and the median CD4 nadir was 53 cells/μl. Frailty was identified among 90 (54.9%) subjects with 84 (51.2%) identified as pre-frail and 6 (3.7%) as frail, with dominant frailty phenotype was weakness in grip strength. The multivariate model showed that depression was the only factor significantly correlated with pre-frailty and frailty (OR 2.14; 95% CI 1.04-4.43, p=0.036). Conclusion: Frailty is a common occurrence among HIV-infected patients under ART, with depression as an independent predictive factor.

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“…Recent studies have also shown that inequalities and inequities have grown among Colombian older adults ( 8 – 17 ). Significant associations have been found between indicators of health and SDH, including age and gender ( 8 , 9 ), skin color ( 10 ), chronic conditions ( 11 ), frailty ( 12 , 13 ), functional limitations ( 14 ), health care utilization ( 15 ), use of psychotropic drugs ( 16 ), and social capital ( 17 ). All of these factors, together with other SDH, are relevant to understanding the health status of older adults as part of the processes of exclusion and discrimination that have consequences for health inequities in the region.…”

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confidence: 99%

Healthy aging determinants and disability among older adults: SABE Colombia

Gómez

Osorio-García

Panesso

et al. 2021

Revista Panamericana De Salud Pública

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Objective. To identify the main factors associated with disability in older adults in Colombia, adjusted according to structural and intermediary determinants of healthy aging. Methods. This study used cross-sectional data from 23 694 adults over 60 years of age in the SABE Colombia nationwide survey. Structural determinants such as demographic and socioeconomic position variables were analyzed. Intermediary variables were classified into three blocks: intrinsic capacity, physical and built environment, and health care systems. Data analysis employed multivariate logistic regression. Results. The prevalence of overall disability was 21% for activities of daily living, 38% for instrumental activities of daily living, and 33% for mobility disability. Disability was associated with sociodemographic structural determinants such as older age, female sex, rural residence, never married/divorced, living alone, low educational level, and Indigenous/Black ethnicity. With regard to determinants of socioeconomic position, net low income, poor socioeconomic stratum, insufficient income perception, and a subsidized health insurance scheme exerted a major influence on disability. Intermediary determinants of intrinsic capacity, such as poor self-rated health, multimorbidity, low grip strength, sedentary lifestyle, early childhood economic adversity, no social support, and no participation in activities, were significantly associated with disability. Conclusions. Actions that affect the main factors associated with disability, such as reducing health inequities through policies, strategies, and activities, can contribute significantly to the well-being and quality of life of Colombian older adults.

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Social and Economic Predictors of Worse Frailty Status Occurrence Across Selected Countries in North and South America and Europe

Cited by 18 publications

References 40 publications

Global Incidence of Frailty and Prefrailty Among Community-Dwelling Older Adults

Global Incidence of Frailty and Prefrailty Among Community-Dwelling Older Adults

Frailty among HIV-1 Infected Adults under Antiretroviral Therapy in Indonesia

Healthy aging determinants and disability among older adults: SABE Colombia

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