Frailty in the Ibadan study of aging- characterization and association with disability, quality of life and healthcare utilization

Abstract

Objectives: Variability in the prevalence of frailty in older populations suggests a need for context specific information about the phenotype. We characterized a frailty phenotype variant in community dwelling Yoruba Nigerians who were aged 60 years or over. Methods: Cross-sectional analysis of the first of three follow-up waves in a five-year prospective study of a household multistage sample of 1595 stroke - and dementia-free persons. We characterized frailty by relying on locally validated tools and the Cardiovascular Health Study (CHS) principle of 'vicious cycle of decline’. The association of frailty with disability, quality of life (QoL) and healthcare utilization was investigated using multivariate logistic regression analyses. Results: We found a prevalence of 7.3% (95% C. I=5.9-9.0) for the full frail phenotype and 62.1% (95% C. I=59.9-64.3) for the prefrail phenotype. In fully adjusted logistic regression models, frail respondents had approximately two, five and eight times the odds of greater healthcare utilization (O. R=1.8, 95% C. 1=1.2-2.7), disability (O. R=5.4, 95% C. I=3.2-9.2) and poor QoL (O. R=8.4, 95% C. I=4.8-14.6) respectively. Conclusion: The prevalence of frailty in this population is similar to those reported in other surveys. The results suggest that with cohort specific modifications, the risk profile of frailty as originally conceptualized in North Americans is applicable to, and has suggestive evidence of validity in, this sub-Saharan African population.