Association between frailty and disability trajectories among older adults in 29 European countries: Evidence from the Survey of Health, Ageing and Retirement in Europe (2004-2019)

Background Frailty is associated with adverse health outcomes in ageing populations, yet there is limited evidence of its long-term negative effect on disability outcomes. The present study examines to what extent frailty affects disability trajectories over a 15-year follow-up in older adults aged 50 and above.

Method Using seven waves of data from the Survey of Health, Ageing and Retirement in Europe (SHARE), the study examines the effect of baseline frailty on subsequent disability trajectories through multilevel growth curve modelling. The sample included 94,313 individuals contributing to 305,421 total observations from 29 European countries. Baseline frailty was assessed using the sex-specific SHARE-Frailty-Instrument (SHARE-FI), which includes weight loss, exhaustion, muscle weakness, slowness, and low physical activity. The two primary outcomes were the number of limitations in Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Analyses were stratified by sex.

Results The mean age of study participants for both sexes was 64 years. Frailty prevalence at baseline differed between males (87% robust, 10% pre-frail, 2% frail) and female participants (70% robust, 21% pre-frail, 9% frail). After controlling for socio-demographic status, a consistent increase in ADL and IADL slope disability trajectories was observed across all frailty groups from the age of 50 onwards, spanning a 15-year follow-up period. Frailty difference was observed in disability trajectories, with frail participants consistently exhibiting elevated disability trajectories across all age groups. While both ADL and IADL disability trajectories display a non-linear increase over time, a steeper slope in IADL limitations was observed compared to ADL limitations across all frailty groups. This was evident in both women (βADL = 0.183, 95% CI = 0.176; 0.190; βIADL = 0.266, 95% CI = 0.257; 0.274) and men (βADL = 0.174, 95% CI = 0.166; 0.183; βIADL = 0.237, 95% CI = 0.233; 0.249).

Conclusion Early assessment of the SHARE-FI frailty assessment in individuals aged 50 years and older offers valuable insight into future disability outcomes. The study findings contribute to the significance of policy interventions aimed at reducing the prevalence of frailty among older adults.

 

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Artikel online veröffentlicht:
05. Dezember 2024