Abstract
BackgroundSince older adults spend much time in their home environment (HE), frailty may occur as a consequence of a maladaptation to the HE. The aim of this study was to describe the prevalence of frailty in the very old population of North Rhine-Westphalia, and to examine the association between the HE and the frailty levels of these individuals.MethodsData from a cross-sectional representative study were used, including data on 1577 community-dwelling individuals and nursing home residents aged ≥ 80 years. Objective and subjective HE aspects were included. Frailty was defined according to four criteria: exhaustion, unintentional weight loss, weakness, and low physical activity. Adjusted multinomial regression modelling was used to analyze the link between the HE and frailty levels.ResultsOf the very old individuals, 24.3% were robust, 57.0% were prefrail, and 18.7% were frail. Adjusting for relevant sociodemographic and health characteristics, being not closely attached to the HE was linked with an increased probability of being prefrail and frail. An improvement of the residential area was associated with a decrease in odds of being frail. Living in communities with less than 50,000 and with 100,000–499,999 inhabitants decreased the odds of being frail.DiscussionFrailty prevalence is shown to be higher in the very old population than in the younger age groups in Germany. Early identification of frailty and tailored interventions focused on improving objective and subjective attributes of the HE are needed to reduce the risk of frailty.Supplementary InformationThe online version of this article (10.1007/s00391-021-01969-6) contains supplementary material, which is available to authorized users.
Highlights
Environmental gerontology proposes that people’s home environment (HE) influences their quality of life at older ages, since older people spend most of their time at home [28]
As frailty is characterized by an increased vulnerability to external stressors [13] and is associated with adverse health outcomes, including mortality [2, 11], hospitalization [16, 19] and nursing home admission [6, 16], we assume that unfavorable objective HE conditions and negative HE experiences are associated with frailty status in very old adults (VOA)
Of the VOA in North RhineWestphalia (NRW), 24.3% (95% confidence interval, CI, 22.3–26.5%) were classified as robust, 57.0% were found to be prefrail, and 18.7% were found to be frail
Summary
Environmental gerontology proposes that people’s home environment (HE) influences their quality of life at older ages, since older people spend most of their time at home [28]. If an individual’s loss of competence can no longer be compensated for by the existing HE conditions, or by the person’s subjective HE experience because of limited coping options, a socalled person-environment misfit occurs [28]. This imbalance can lead to increased stress, restricted autonomy and health decline [28]. In line with the “Challenges and Potentials Model of Quality of Life in Very Old Age” [27], this study focused on the link between environmental conditions and individual resources. Identification of frailty and tailored interventions focused on improving objective and subjective attributes of the HE are needed to reduce the risk of frailty
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