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

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, socioeconomic status (SES) 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 [1.26–1.78]) and frailty development (OR 1.39, CI [1.13–1.69]) were significantly associated with perceived age discrimination in the fully adjusted models. Age (80 + years) and long-standing illness had the strongest association with respondents’ frailty outcome; odds ratios (OR 3.67, CI [2.81–4.80]) and (OR 5.61, CI [4.55–6.92]) respectively. Conclusion: Perceived age discrimination significantly increased the risk of frailty progression and frailty development among ELSA participants.