Samenvatting
Objective To evaluate the pattern of frailty across several of social stratifiers associated with health inequalities. Design, setting and participants Cross-sectional baseline data on 51 338 community-living women and men aged 45-85 years from the population-based Canadian Longitudinal Study on Aging (collected from September 2011 to May 2015) were used in this study. Primary outcomes and measures A Frailty Index (FI) was constructed using self-reported chronic conditions, psychological function and cognitive status and physical functioning variables. Social stratifiers were chosen based on the Pan-Canadian Health Inequalities Reporting Initiative, reflecting key health inequalities in Canada. Unadjusted and adjusted FIs and domain-specific FIs (based on chronic conditions, physical function, psychological/cognitive deficits) were examined across population strata. Results The overall mean FI was 0.13±0.08. It increased with age and was higher in women than men. Higher mean FIs were found among study participants with low income (0.20±0.10), who did not complete secondary education (0.17±0.09) or had low perceived social standing (0.18±0.10). Values did not differ by Canadian province of residence or urban/rural status. After simultaneously adjusting for population characteristics and other covariates, income explained the most heterogeneity in frailty, especially in younger age groups; similar patterns were found for men and women. The average frailty for people aged 45-54 in the lowest income group was greater than that for those aged 75-85 years. The heterogeneity in the FI among income groups was greatest for the psychological/cognitive domain. Conclusions Our results suggest that especially in the younger age groups, psychological/cognitive deficits are most highly associated with both overall frailty levels and the gradient in frailty associated with income. If this is predictive of later increases in the other two domains (and overall frailty), it raises the question whether targeting mental health factors earlier in life might be an effective approach to mitigating frailty.
| Originele taal-2 | Engels |
|---|---|
| Artikelnummer | e047945 |
| Aantal pagina's | 11 |
| Tijdschrift | BMJ open |
| Volume | 11 |
| Nummer van het tijdschrift | 7 |
| DOI's | |
| Status | Gepubliceerd - 19 jul. 2021 |
Bibliografische nota
Publisher Copyright:© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Financiering
Funding This research was made possible using the data/biospecimens collected by the Canadian Longitudinal Study on Aging (CLSA). Funding for the CLSA is provided by the Government of Canada through the Canadian Institutes of Health Research under grant reference: LSA 94473 and the Canada Foundation for Innovation. This research has been conducted using the CLSA dataset Baseline Tracking V.3.1 and Baseline Comprehensive V.2.0, under application number 150306. The CLSA is led by Drs. Parminder Raina, Christina Wolfson and Susan Kirkland. This study was supported by a Canadian Institutes of Health Research Catalyst Grant (FRN 151287). Lauren Griffith is supported by the McLaughlin Foundation Professorship in Population and Public Health. Parminder Raina holds a Tier 1 Canada Research Chair in Geroscience and the Raymond and Margaret Labarge Chair in Research and Knowledge Application for Optimal Aging.
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