Abstract
Frailty is garnering increasing interest as a potential target in disability prevention. Since it is uncertain how frailty interacts with multimorbidity, urbanization, and mental health to affect disability, we investigated the epidemiology of frailty and its synergies with these factors. The study enrolled 20,898 participants aged 65 and older living in New Taipei city. All participants received face to face interview to assess frailty, multimorbidity, urban or rural residence, and mental health. Individual versus combined effects of risk factors were evaluated using the Rothman synergy index. Prevalence of frailty was 5.2% overall, 7.2% in multimorbid participants, 9.6% in rural residents, and 20.8% in those with mental disorders. Logistic regression, adjusted for age and sex, showed significant associations between disability and frailty (OR 8.5, 95% CI 6.4–11.2), multimorbidity (OR 1.3, 95% CI 1.0–1.6), urbanization (OR 1.3, 95% CI 1.0–1.7), and mental disorders (OR 7.3, 95% CI 5.6–9.5); these factors had a significant synergic effect on disability. Frailty is common in older adults and associated with disability, and was synergetic with multimorbidity, mental disorders, and residing rurally. Targeting frailty prevention and intervention needs a special attention on those vulnerable groups.
Highlights
With increasing life-expectancy and decreasing fertility, population aging has become a global phenomenon and is occurring more rapidly in Asia than elsewhere
The majority of participants were more than 70 years old, and women (Table 1)
Frailty was more prevalent among vulnerable subjects, i.e. those with multimorbidity (7.2%) or mental disorders (20.8%), and residing rurally (9.7%)
Summary
With increasing life-expectancy and decreasing fertility, population aging has become a global phenomenon and is occurring more rapidly in Asia than elsewhere. There are disparities in health and mortality between people of different socioeconomic status and who live in rural rather than urban areas[9,10,11,12] It is uncertain, whether or not frailty is more prevalent in rural areas or interacts synergistically with low urbanization to affect functional dependence, and what potential implications there may be in terms of the prevalence and rate of population aging. Whether or not frailty is more prevalent in rural areas or interacts synergistically with low urbanization to affect functional dependence, and what potential implications there may be in terms of the prevalence and rate of population aging Understanding such differences may help policymakers and health professionals to mobilize resources and develop customized strategies for preventing and managing disability. This study evaluated the impact of frailty on disability and investigated whether urbanization and mental health may exert synergistic effects
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