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Determinants of frailty development and progression using a multidimensional frailty index: Evidence from the English Longitudinal Study of Ageing.

ABSTRACT: OBJECTIVE:To identify modifiable risk factors for development and progression of frailty in older adults living in England, as conceptualised by a multidimensional frailty index (FI). METHODS:Data from participants aged 50 and over from the English Longitudinal Study of Ageing (ELSA) was used to examine potential determinants of frailty, using a 56-item FI comprised of self-reported health conditions, disabilities, cognitive function, hearing, eyesight, depressive symptoms and ability to carry out activities of daily living. Cox proportional hazards regression models were used to measure frailty development (n = 7420) and linear regression models to measure frailty progression over 12 years follow-up (n = 8780). RESULTS:Increasing age (HR: 1.08 (CI: 1.08-1.09)), being in the lowest wealth quintile (HR: 1.79 (CI: 1.54-2.08)), lack of educational qualifications (HR: 1.19 (CI: 1.09-1.30)), obesity (HR: 1.33 (CI: 1.18-1.50) and a high waist-hip ratio (HR: 1.25 (CI: 1.13-1.38)), being a current or previous smoker (HR: 1.29 (CI: 1.18-1.41)), pain (HR: 1.39 (CI: 1.34-1.45)), sedentary behaviour (HR: 2.17 (CI: 1.76-2.78) and lower body strength (HR: 1.07 (CI: 1.06-1.08)), were all significant risk factors for frailty progression and incidence after simultaneous adjustment for all examined factors. CONCLUSION:The findings of this study suggest that there may be scope to reduce both frailty incidence and progression by trialling interventions aimed at reducing obesity and sedentary behaviour, increasing intensity of physical activity, and improving success of smoking cessation tools. Furthermore, improving educational outcomes and reducing poverty may also reduce inequalities in frailty.

SUBMITTER: Niederstrasser NG

PROVIDER: S-EPMC6821067 | biostudies-other | 2019

REPOSITORIES: biostudies-other

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Determinants of frailty development and progression using a multidimensional frailty index: Evidence from the English Longitudinal Study of Ageing.

Niederstrasser Nils Georg NG Rogers Nina Trivedy NT Bandelow Stephan S

PloS one 20191030 10

<h4>Objective</h4>To identify modifiable risk factors for development and progression of frailty in older adults living in England, as conceptualised by a multidimensional frailty index (FI).<h4>Methods</h4>Data from participants aged 50 and over from the English Longitudinal Study of Ageing (ELSA) was used to examine potential determinants of frailty, using a 56-item FI comprised of self-reported health conditions, disabilities, cognitive function, hearing, eyesight, depressive symptoms and abi ...[more]

PMID: 31665163

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Project description:BackgroundPain has been suggested to act as a stressor during aging, potentially accelerating declines in health and functioning. Our objective was to examine the longitudinal association between self-reported pain and the development, or worsening, of frailty among older men and women.MethodsThe study population consisted of 5,316 men and women living in private households in England, mean age 64.5 years, participating in the English Longitudinal Study of Ageing (ELSA). Data from Waves 2 and 6 of ELSA were used in this study with 8 years of follow-up. At Wave 2, participants were asked whether they were "often troubled with pain" and for those who reported yes, further information regarding the intensity of their pain (mild, moderate, or severe) was collected. Socioeconomic status (SES) was assessed using information about the current/most recent occupation and also net wealth. A frailty index (FI) was generated, with the presence of frailty defined as an FI >0.35. Among those without frailty at Wave 2, the association between pain at Wave 2 and frailty at Wave 6 was examined using logistic regression. We investigated whether pain predicted change in FI between Waves 2 and 6 using a negative binomial regression model. For both models adjustments were made for age, gender, lifestyle factors, depressive symptoms, and socioeconomic factors.ResultsAt Wave 2, 455 (19.7%) men and 856 (28.7%) women reported they often experienced moderate or severe pain. Of the 5,159 participants who were nonfrail at Wave 2, 328 (6.4%) were frail by Wave 6. The mean FI was 0.11 (standard deviation [SD] = 0.1) at Wave 2 and 0.15 (SD = 0.1) at Wave 6. After adjustment for age, gender, body mass index, lifestyle factors, and depressive symptoms, compared to participants reporting no pain at Wave 2 those reporting moderate (odds ratio [OR] = 3.08, 95% confidence interval [CI] = 2.28, 4.16) or severe pain (OR = 3.78, 95% CI = 2.51, 5.71) were significantly more likely to be frail at Wave 6. This association persisted after further adjustment for either occupational class and/or net wealth level. Compared to those without pain, those with mild, moderate, or severe pain were also more likely to develop worsening frailty, as assessed using the FI, and this association persisted after adjustment for SES. There was no evidence that the association between pain and frailty was influenced by gender.ConclusionPain is associated with an increased risk and intensity of frailty in older men and women. Socioeconomic factors contribute to the occurrence of frailty; though in our study do not explain the relationship between pain and frailty.

Dataset Information

Determinants of frailty development and progression using a multidimensional frailty index: Evidence from the English Longitudinal Study of Ageing.

Publications

Determinants of frailty development and progression using a multidimensional frailty index: Evidence from the English Longitudinal Study of Ageing.

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