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

Solveig A. Arnadottir*, Julie Bruce, Ranjit Lall, Emma J. Withers, Martin Underwood, Fiona Shaw, Ray Sheridan, Anower Hossain, Sarah E. Lamb, Finbarr Martin, Lucy Yardley, Dawn Skelton, Keith Willett, Sandra Eldridge, Anne Marie Slowther, Sarah Duggan, Julie Bruce, Susie Hennings, Emma Withers, Rhys MantRishpal Rai, Craig Turner, Agata Andrews, Rachael Fearn, Susanne Finnegan, Nicola Walker, Rachel Potter, Ranjit Lall, Claire Hulme, Chris Bojke, Roberta Longo, Susanne Finnegan, Katherine Westacott, Shvaita Ralhan, Ray Sheridan, Jonathan Treml, Ray Sheridan, Jackie Riglin, Harm Gordjin, Ruma Dutta, Jo Burns, Jonathan Treml, Fiona Shaw, John Davison, Ade Willis, Chocks Muthiah, Henry Adjei

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Background: The 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. Methods: Analysis 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. Results: Mean 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. Conclusions: Physical 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.

Original languageEnglish
Article number16
JournalBMC Geriatrics
Issue number1
Publication statusPublished - 15 Jan 2020

Bibliographical note

Funding Information:
Professor Sarah Lamb funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Oxford at Oxford Health NHS Foundation Trust and NIHR Biomedical Research Centre at the Oxford University Hospitals NHS Trust. Professor Julie Bruce is funded by NIHR Research Capability Funding. The funding bodies had no role in the design, data collection, data analysis, data interpretation, or writing of the manuscript.

Funding Information:
The PreFIT study is funded by the National Institute of Health Research Technology Assessment Programme (Nir HTA), project number 08/14/41. The views expressed in this publication are those of the authors and not necessarily those of the NIHR or Department of Health. This project benefited from facilities funded by Birmingham Science City Translational Medicine Clinical Research and Infrastructure Trials Platform, with support from Advantage West Midlands (AWM). The trial sponsor is the University of Warwick. The trial started in September 2010 and was funded until 2018.

Publisher Copyright:
© 2020 The Author(s).

Other keywords

  • Aging
  • Frailty
  • Hearing
  • Population characteristics
  • Sensation
  • Vision


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