Abstract
Marital status is an important risk factor for physical frailty. However, there are limited data on spousal concordance of physical frailty among married couples. Here, we evaluate the spousal concordance of frailty as defined by the Fried frailty phenotype and specific phenotype components that contribute to this association. Data on 315 married couples (630 individuals) aged between 70 and 84 years were obtained from the Korean Frailty and Aging Cohort Study (KFACS). Multivariate logistic regressions were used for the analysis. After adjusting for covariates (age, body mass index, education, house ownership, comorbidity, cognition, depressive symptoms, cohabitation with adult children for both partners), a husband’s frailty was positively associated with his wife’s frailty (odds ratio (OR) 3.34, 95% confidence interval (CI) 1.04–10.73, p < 0.05), and a wife’s frailty was significantly associated with her husband’s frailty (OR 4.62, 95% CI 1.31–16.33, p < 0.05), indicating a greater effect of the frailty status of the spouse among women than among men. Among the five components of the Fried frailty phenotype, weight loss, slowness, and exhaustion were the main contributing factors to the spousal association for frailty. In conclusion, having a frail spouse is a strong and independent risk factor for frailty among community-living older adults.
Highlights
We evaluated the spousal concordance of frailty among older adults and determined the specific frailty phenotype components that contribute to this association
We found a spousal concordance for frailty among community-living older adults
We identified that three components of the Fried frailty phenotype, namely, weight loss, slowness, and exhaustion, mainly contribute to the spousal association for frailty
Summary
By 2050, the proportion of the population over 60 years old will almost double from 12% to 22%, reaching up to 434 million worldwide [1]. Frailty is a state of functional decline and increased vulnerability, commonly defined by the Fried phenotype model and the frailty index [4,5,6]. The Fried phenotype model is a physical frailty criterion, and the frailty index is a cumulative health deficits index including physical, psychological, mental, and social functions [4,6]. In community-dwelling adults aged ≥65 years, the estimated prevalence of frailty is around 10%, and the incidence may increase with age [7,8]. Frailty may have a high health care burden since it is associated with increased morbidity and mortality in the elderly [9,10]
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