Frailty Index in the Colonias on the US-Mexico Border: A Special Report.

Eron G Manusov,Carolina Gomez De Ziegler,Gerardo Munoz-Monaco,Vincent P Diego,Sarah Williams-Blangero

doi:10.3389/fmed.2021.650259

Eron G Manusov, Carolina Gomez De Ziegler + Show 3 more

Open Access

https://doi.org/10.3389/fmed.2021.650259

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Abstract

Frailty is the age-related decline in well-being. The Frailty index (FI) measures the accumulation of health deficits and reflects biopsychosocial and cultural determinants of well-being. Frailty is measured as a static phenotype or as a Frailty Index comprising a ratio of suffered health deficits and total deficits. We report a Frailty Index calculated from routinely measured clinical variables gathered from residents of two Colonias (neighborhoods) in South Texas. A Colonia is a predominantly Hispanic, economically distressed, unincorporated neighborhood. We analyzed retrospective data from 894 patients that live in two Colonias located on the Texas-Mexico border. We calculated the FI with seven physiological variables, PHQ-9 score, and the 11 domain-specific Duke Profile scores, for a total of 19 possible health deficits. FI against age separately in males (n = 272) and females (n = 622) was regressed. Females had a significantly higher starting frailty, and males had a significantly greater change rate with age. FI against age for Cameron Park Colonia and Indian Hills Colonia was regressed. We calculated a significantly higher starting FI in Indian Hills and a significantly greater change rate in Cameron Park residents. Frailty's contributors are complex, especially in neighborhoods of poverty, immigration, low education level, and high prevalence of chronic disease. We report baseline Frailty Index data from two Colonias in South Texas and the clinical and research implications.

Highlights

Socioeconomic status, poverty, social determinants of health, and health disparities contribute to Frailty and affect healthcare planning and delivery
Cameron Park was selected as the representative “green” Colonia because of a long history of an Abbreviations: Frailty index (FI), Frailty Index; SEL, Socioeconomic Level; high-density lipoprotein (HDL), HighDensity Lipoprotein; LDL, Low-Density Lipoprotein; Patient Health Questionnaire9 (PHQ-9), Patient Health Questionnaire 9; HrQOL, Health-Related Quality of Life; systolic blood pressure (SBP), Systolic Blood Pressure; HbA1C, Hemoglobin A1C
The plot of the difference of means as calculated by Hoteling T2 is the squared difference of mean vectors scaled against the covariance matrix for age, systolic blood pressure (SBP), HbA1c (A1c), high-density lipoprotein (HDL), total cholesterol (Chol), physical health (Phys), mental health, perceived health (Perc), anxiety (Anx), anxiety-depression (A_D), pain, and disability (Disab) compared across both Colonias

Summary

Introduction

Socioeconomic status, poverty, social determinants of health, and health disparities contribute to Frailty and affect healthcare planning and delivery. Frailty is associated with chronic disease, aging, and quality of life. The use of a Frailty Index can identify known and unknown contributors to health and wellbeing targeted in healthcare delivery and research across the lifespan. Multiple variables, such as age, chronic illness, health, and well-being, contribute to Frailty, and increased Frailty, is associated with higher mortality [11,12,13,14,15,16,17,18,19,20,21,22,23,24]

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