The online version of this article (https://doi.org/10.1186/s12877-017-0694-y) contains supplementary material, which is available to authorized users.
Frailty is a key predictor of death and dependency, yet little is known about frailty in sub-Saharan Africa despite rapid population ageing. We describe the prevalence and correlates of phenotypic frailty using data from the Health and Aging in Africa: Longitudinal Studies of an INDEPTH Community cohort.
We analysed data from rural South Africans aged 40 and over. We used low grip strength, slow gait speed, low body mass index, and combinations of self-reported exhaustion, decline in health, low physical activity and high self-reported sedentariness to derive nine variants of a phenotypic frailty score. Each frailty category was compared with self-reported health, subjective wellbeing, impairment in activities of daily living and the presence of multimorbidity. Cox regression analyses were used to compare subsequent all-cause mortality for non-frail (score 0), pre-frail (score 1–2) and frail participants (score 3+).
Five thousand fifty nine individuals (mean age 61.7 years, 2714 female) were included in the analyses. The nine frailty score variants yielded a range of frailty prevalences (5.4% to 13.2%). For all variants, rates were higher in women than in men, and rose steeply with age. Frailty was associated with worse subjective wellbeing, and worse self-reported health. Both prefrailty and frailty were associated with a higher risk of death during a mean 17 month follow up for all score variants (hazard ratios 1.29 to 2.41 for pre-frail vs non-frail; hazard ratios 2.65 to 8.91 for frail vs non-frail).
Phenotypic frailty could be measured in this older South African population, and was associated with worse health, wellbeing and earlier death.
Additional file 1: Table S1. List of components used to construct each frailty score variant tested. Table S2. Prevalence of, and correlations between, each frailty score component used from HAALSI. Table S3. Association between frailty score variants, wellbeing, self-reported health, and ADL impairment in HAALSI. Table S4. Hazard ratios for time to death for frailty categories in HAALSI. Table S5. Discrimination of different frailty score variants to predict death at one year. (DOCX 20 kb)
Additional file 2: Definitions of multimorbidity and other outcomes. Additional methods describing disease and multimorbidity definitions, activities of daily living and subjective wellbeing measures. (DOCX 16 kb)
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- Prevalence and correlates of frailty in an older rural African population: findings from the HAALSI cohort study
Collin F. Payne
Chodziwadziwa W. Kabudula
Justine I. Davies
Angela Y. Chang
F. Xavier Gomez-Olive
Lisa F. Berkman
Stephen M. Tollman
Joshua A. Salomon
Miles D. Witham
- BioMed Central
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