Patterns of Frailty in Older Adults: Comparing Results from Higher and Lower Income Countries Using the Survey of Health, Ageing and Retirement in Europe (SHARE) and the Study on Global AGEing and Adult Health (SAGE)
We use the method of deficit accumulation to describe prevalent and incident levels of frailty in community-dwelling older persons and compare prevalence rates in higher income countries in Europe, to prevalence rates in six lower income countries. Two multi-country data collection efforts, SHARE and SAGE, provide nationally representative samples of adults aged 50 years and older. Forty items were used to construct the frailty index in each data set. Our study shows that the level of frailty was distributed along the socioeconomic gradient in both higher and lower income countries such that those individuals with less education and income were more likely to be frail. Frailty increased with age and women were more likely to be frail in most countries. Across samples we find that the level of frailty was higher in the higher income countries than in the lower income countries.
References
[1]
Strawbridge WJ, Shema SJ, Balfour JL, Higby HR, Kaplan GA (1998) Antecedents of frailty over three decades in an older cohort. The Journals of Gerontology: Series B: Social Sciences 53: 9–16.
[2]
Walston J, Hadley EC, Ferrucci L, Guralnik JM, Newman AB, et al. (2006) Research agenda for frailty in older adults: toward a better understanding of the physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. Journal of the American Geriatrics Society 54: 991–1001.
[3]
Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G (2004) Untangling the concepts of disability, frailty and comorbidity: implications for improved targeting and care. The Journals of Gerontology: Series A: Medical Sciences 59: 255–263.
[4]
Abellan van Kan KG, Rolland Y, Bergman H, Morley JE, Kritchevsky SB, et al. (2008) The I.A.N.A. Task Force on frailty assessment of older people in clinical practice. The Journal of Nutrition Health and Aging 12: 29–37.
[5]
Satariano WA (1997) The disabilities of aging-looking to the physical environment. American Journal of Public Health 87: 331–332.
[6]
Lang PO, Michel JP, Zekry D (2009) Frailty syndrome: a transitional state in a dynamic process. Gerontology 55: 539–549.
[7]
Fulop T, Larbi A, Witkowski JM, McElhaney J, Loeb M, et al. (2010) Aging, frailty and age-related diseases. Biogerontology 11: 547–563.
[8]
Abellan van Kan G, Rolland Y, Houles M, Gillette-Guyonnet S, Soto M, et al. (2010) The assessment of frailty in older adults. Clinics in Geriatric Medicine 26: 275–286.
[9]
Rodríguez-Ma？as L, Féart C, Mann G, Vi？a J, Chatterji S, et al. (2013) Searching for an operational definition of frailty: a delphi method based consensus statement: the frailty operative definition-consensus conference project. The Journals of Gerontology: Series A: Biological Sciences and Medical Sciences 68: 62–67.
[10]
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, et al. (2001) Frailty in older adults: evidence for a phenotype. The Journals of Gerontology: Series A: Biological Sciences and Medical Sciences 56: 146–156.
[11]
Rockwood K, Song X, Macknight C, Bergman H, Hogan DB, et al. (2005) A global clinical measure of fitness and frailty in elderly people. Canadian Medical Association Journal 173: 489–495.
[12]
Rockwood K, Andrew M, Mitnitski A (2007) A comparison of two approaches to measuring frailty in elderly people. The Journals of Gerontology: Series A: Biological Sciences and Medical Sciences 62: 738–743.
[13]
Song X, Mitnitski A, Rockwood K (2010) Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation. Journal of the American Geriatrics Society 58 4 681–687.
[14]
Klevmarken NA, Hesselius P, Swensson B (2005) The SHARE sampling procedures and calibrated design weights. In AB？rsch-Supan, HJürges (Eds.) The Survey of Health, Ageing and Retirement in Europe. Mannheim Research Institute for the Economics of Aging.
[15]
United Nations (2011) World Population Prospects: The 2010 Revision. United Nations Population Division.
[16]
UNESCO (2006) International Standard Classification of Education: ISCED 1997.
[17]
Gakidou E, Oza S, Fuetes CV, Li AY, Lee DK, et al. (2007) Improving child survival through environmental and nutritional interventions. The importance of targetting interventions towards the poor. Journal of the American Medical Association 298: 1876–1887.
[18]
Hosseinpoor AR, Mohammad K, Majdzadeh R, Naghavi M, Abolhassani F, et al. (2005) Socioeconomic inequality in infant mortality in Iran and across its provinces. Bulletin of the World Health Organisation 83: 837–844.
[19]
Ferguson B, Murray CL, Tandon A, Gakidou E (2003) Estimating permanent income using asset and indicator variables. In C.LMurray, D.BEvans (Eds.) Health systems performance assessment debates, methods and empiricism. World Health Organization.
[20]
Searle SD, Mitnitski AB, Gahbauer EA, Gill TM, Rockwood K (2008) A standard procedure for creating a frailty index. BMC Geriatrics 8: 24.
[21]
Ferrucci L, Guralnik JM, Studenski S, Fried LP, Cutler GB Jr, et al. (2004) Interventions on frailty working group. Designing randomized controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: a consensus report. Journal of the American Geriatrics Society 52: 625–634.
[22]
Mitnitski AB, Mogilner AJC, Rockwood K (2001) Accumulation of deficits as a proxy measure of aging. Scientific World Journal 1: 323–336.
[23]
Mitnitski AB, Graham JE, Mogilner AJ, Rockwood K (2002) Frailty, fitness and late-life mortality in relation to chronological and biological age. BMC Geriatrics 2: 1.
[24]
Romero-Ortuno R, Kenny RA (2012) The frailty index in Europeans: association with age and mortality. Age and Ageing 41: 684–689.
[25]
Rockwood K, Mitnitski A (2007) Frailty in relation to the accumulation of deficits. The Journals of Gerontology: Series A: Biological Sciences and Medical Sciences 62: 722–727.
[26]
Ahmad OB, Boschi-Pinto C, Lopez AD, Murray CJL, Lozano R, et al.. (2001) Age Standardization of Rates: A new WHO Standard. GPE Discussion Paper No. 31, World Health Organization.
[27]
Sternberg SA, Wershof Schwartz A, Karunananthan S, Bergman H, Mark Clarfield A (2011) The identification of frailty: a systematic literature review. Journal of the American Geriatrics Society 59: 2129–2138.
[28]
Collard RM, Boter H, Schoevers RA, Oude Voshaar RC (2012) Prevalence of frailty in community-dwelling older persons: a systematic review. Journal of the American Geriatrics Society 60: 1487–1492.
[29]
Pijpers E, Ferreira I, Stehouwer CD, Nieuwenhuijzen Kruseman AC (2012) The frailty dilemma. Review of the predictive accuracy of major frailty scores. European Journal of Internal Medicine 23: 118–123.
[30]
Heuberger RA (2011) The frailty syndrome: a comprehensive review. Journal of Nutrition in Gerontology and Geriatrics 30: 315–368.
