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The importance of different frailty domains in a population based sample in England

  • Arnadottir, Solveig A.1
  • Bruce, Julie2
  • Lall, Ranjit2
  • Withers, Emma J.2
  • Underwood, Martin2
  • Shaw, Fiona3
  • Sheridan, Ray4
  • Hossain, Anower5
  • Lamb, Sarah E.2, 6
  • Lamb, Sarah E.
  • Underwood, Martin
  • Martin, Finbarr
  • Yardley, Lucy
  • Skelton, Dawn
  • Willett, Keith
  • Eldridge, Sandra
  • Slowther, Anne-Marie
  • Duggan, Sarah
  • Bruce, Julie
  • Hennings, Susie
  • And 29 more
  • 1 University of Iceland, Stapi v/Hringbraut, 101, Reykjavik, Iceland , Reykjavik (Iceland)
  • 2 University of Warwick, Coventry, CV4 7AL, UK , Coventry (United Kingdom)
  • 3 The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DN, UK , Newcastle upon Tyne (United Kingdom)
  • 4 Geriatric Medicine, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, Devon, EX2 5DW, UK , Exeter (United Kingdom)
  • 5 Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, Bangladesh , Dhaka (Bangladesh)
  • 6 University of Oxford, Windmill Road, Oxford, OX3 7LD, UK , Oxford (United Kingdom)
Published Article
BMC Geriatrics
BioMed Central
Publication Date
Jan 15, 2020
DOI: 10.1186/s12877-019-1411-9
Springer Nature


BackgroundThe aim was to estimate the prevalence of frailty and relative contribution of physical/balance, nutritive, cognitive and sensory frailty to important adverse health states (falls, physical activity levels, outdoor mobility, problems in self-care or usual activities, and lack of energy or accomplishment) in an English cohort by age and sex.MethodsAnalysis of baseline data from a cohort of 9803 community-dwelling participants in a clinical trial. The sample was drawn from a random selection of all people aged 70 or more registered with 63 general practices across England. Data were collected by postal questionnaire. Frailty was measured with the Strawbridge questionnaire. We used cross sectional, multivariate logistic regression to estimate the association between frailty domains and known correlates and adjusted for age. Some models were stratified by sex.ResultsMean age of participants was 78 years (sd 5.7), range 70 to 101 and 47.5% (4653/9803) were men. The prevalence of overall frailty was 20.7% (2005/9671) and there was no difference in prevalence by sex (Odds Ratio 0.98; 95% Confidence Interval 0.89 to 1.08). Sensory frailty was the most common and this was reported by more men (1823/4586) than women (1469/5056; Odds Ratio for sensory frailty 0.62, 95% Confidence Interval 0.57 to 0.68). Men were less likely than women to have physical or nutritive frailty. Physical frailty had the strongest independent associations with adverse health states. However, sensory frailty was independently associated with falls, less frequent walking, problems in self-care and usual activities, lack of energy and accomplishment.ConclusionsPhysical frailty was more strongly associated with adverse health states, but sensory frailty was much more common. The health gain from intervention for sensory frailty in England is likely to be substantial, particularly for older men. Sensory frailty should be explored further as an important target of intervention to improve health outcomes for older people both at clinical and population level.Trial registrationISRCTN71002650.

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