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Abstract
Frailty is prevalent in the rural elderly and, as a result, they are vulnerable to serious health problems. The purpose of this study was to examine the multilevel factors affecting frailty among the rural elderly using the ecological model. A total of 386 participants aged 65 years or older from 60 rural areas were included in the study. Frailty was measured using the Cardiovascular Health Study frailty index. Multilevel logistic regression analysis was used to identify the factors affecting frailty among the rural elderly. The results show that the levels of prevalence for robust, pre-frailty, and frailty groups were 81 (21%), 216 (56%), and 89 (23%), respectively. As for intrapersonal factors, old age, lower than middle school education, low and moderate levels of physical activity, depressive symptoms, and cognitive dysfunction significantly increased the risk of frailty; however, no interpersonal and community factors were significant in affecting frailty. The findings indicate that individualized strategies to encourage physical activity, prevent depressive symptoms, and preserve cognitive function are needed to prevent frailty in the rural elderly.
Highlights
As the elderly population increases, the prevalence of frailty is steadily increasing.Frailty is defined as a condition of vulnerability to endogenous and exogenous stressors, resulting in negative health consequences, such as mortality, institutionalization, falls, and hospitalization [1,2,3,4]
The purpose of this study was to explore the multilevel factors affecting frailty in the rural elderly based on the ecological model
Given the dearth of studies about the factors related to frailty among the rural elderly, this study examined the prevalence of frailty and multilevel factors that affect frailty based on the ecological model
Summary
As the elderly population increases, the prevalence of frailty is steadily increasing.Frailty is defined as a condition of vulnerability to endogenous and exogenous stressors, resulting in negative health consequences, such as mortality, institutionalization, falls, and hospitalization [1,2,3,4]. As the elderly population increases, the prevalence of frailty is steadily increasing. Frailty is related to social problems, such as the high medical cost of treating diseases in the elderly population [5] and the burden on families and society of taking care of the elderly [6]. It is necessary to reduce frailty in the elderly population. Factors affecting frailty have been widely investigated but research has mainly focused on individual factors, such as sociodemographic, physical, and mental aspects. In terms of sociodemographic aspects, increasing age, being female, and having a lower education and income increase the risk of frailty [7,8]. In terms of physical aspects, having three or more chronic diseases and malnutrition have both been found to be associated with frailty in older adults [8,9]. In terms of mental aspects, depression and anxiety have been found to be risk factors for frailty [10], and cognitive decline has been found to be strongly associated with frailty [11]
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