Is age discrimination a risk factor for frailty progression and frailty development among older adults? A prospective cohort analysis of the English Longitudinal Study of Ageing

Abstract

BACKGROUND: With the increasing global burden of frailty on healthcare resources, it is important to understand the modifiable risk factors of frailty. This study examined perceived age discrimination as a potential risk factor for frailty progression and frailty development among older adults. METHODS: Prospective cohort study using data from Waves 5 to 9 of the English Longitudinal Study of Ageing (ELSA). Data on perceived age discrimination was collected only in Wave 5 of ELSA and analysed as baseline data in this study. Frailty was defined using the Frailty Index (FI) scores (0 to 1), calculated using the multidimensional deficits (scores ≥ 0.25 were considered frail). Binomial generalised estimating equation models (GEE) were fitted in R studio using perceived age discrimination as the main predictor with age, gender, long-standing illness, cognition, subjective social status status (SSS) and psychological wellbeing as covariates. Odd ratios were reported with 95 % confidence intervals (CI). RESULTS: A total sample of 2,385 ELSA participants were included in the analysis. 55.8 % (n = 1312) were female, mean age 71.9 (SD ± 5.27) years and baseline frailty prevalence was 12.1 % (n = 288). Perceived age discrimination was reported by 38.4 % (n = 916) of the participants. Both frailty progression (OR 1.50, CI [1.26- 1.70]) and frailty development (OR 1.39, CI [1.14-1.62]) were significantly associated with perceived age discrimination in the fully adjusted models. Age (80+ years) (OR 3.72, CI [2.84-4.86]) and long-standing illness (OR 5.45, CI [4.43-6.67]) had the strongest association with respondents' frailty progression. CONCLUSION: Perceived age discrimination significantly increased the risk of frailty progression and frailty development among ELSA participants.

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