Prevalence of frailty indicators and association with socio-economic status in middle-aged and older adults in a Swiss region with universal health insurance coverage: a population-based cross-sectional study

Idris Guessous, Jean-Christophe Luthi, Christopher Barrett Bowling, Jean-Marc Theler, Fred Paccaud, Jean-Michel Gaspoz, William McClellan.
Prevalence of Frailty Indicators and Association with Socioeconomic Status in Middle-Aged and Older Adults in a Swiss Region with Universal Health Insurance Coverage: A Population-Based Cross-Sectional Study.Journal of Aging Research, 22 October 2014, doi: 10.1155/2014/198603

Abstract

BACKGROUND: The prevalence of frailty in older people has been previously reported, but remains largely unknown in middle-aged adults. We determined the prevalence of indicators of frailty among middle-aged and older adults in a general Swiss population with universal health insurance coverage. We also assessed the determinants of frailty, with particular emphasis on socio-economic status. 

Method: People aged 50 and over taking part in the Bus Santé 2006-2010 population-based cross-sectional study were included (N = 2,930). Four indicators of frailty (weakness, weight loss, exhaustion and low activity) were measured according to standard definitions. Multivariate logistic regressions were used to determine associations. 

Results: Overall, 63.5% of participants had no indicators of frailty, 28.7% had one, and 7.8% had two or more. Among middle-aged participants (50-65), 75.1% had 0 indicators of frailty, 22.2% had 1 and 2.7% had 2 or more. The number of indicators of frailty was positively associated with age, hypertension and active smoking, and negatively associated with male gender, body mass index, waist-to-hip ratio and serum total cholesterol levels. A lower level of income, but not level of education, was associated with a higher number of indicators of frailty.

Conclusions: Indicators of frailty are frequently observed in older and middle-aged adults in the general Swiss population. Despite universal health insurance coverage, household income is independently associated with frailty.

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