Frailty and Determinants of Health Among Older Adults in the United States 2011–2016

Abstract

Objective To characterize frailty phenotype in a representative cohort of older Americans and examine determinants of health factors. Methods Retrospective analysis of data from 5,553 adults ≥60 years old in the 2011–2016 cross-sectional National Health and Nutrition Examination Survey (NHANES). World Health Organization “ Determinants of Health” conceptual model was used to prioritize variables for multinomial logistic regression for the outcome of modified Fried frailty phenotype. Results 482 participants (9%) were frail and 2432 (44%) prefrail. Four factors were highly associated with frailty: difficulty with ≥1 activity of daily living (77%; OR 24.81 p < 0.01), ≥2 hospitalizations in the previous year (17%, OR 3.94 p < 0.01), having >2 comorbidities (27%; OR 3.33 p < 0.01), and polypharmacy (66%; OR 2.38 p < 0.01). Discussion A modified Fried frailty assessment incorporating five self-reported criteria may be useful as a rapid nursing screen in low-resource settings. These assessments can streamline nursing care coordination and case management activities, thereby facilitating targeted frailty interventions to support healthy aging in vulnerable populations.