Modifiable factors associated with frailty in older Australians in retirement living: A partial proportional odds model

Objective

Frailty in older adults is a vulnerable state, often leading to a reduction in function and quality of life. This study sought to identify modifiable factors associated with frailty in Australian retirement village residents.

Methods

A cross-sectional survey was undertaken with individuals 65 years or older living in 25 retirement villages to collect demographic, health and lifestyle information and screen for frailty (modified Reported Edmonton Frail Scale) and loneliness (UCLA 3-item Loneliness Scale). Partial proportional odds modelling was utilised to determine modifiable resident characteristics associated with frailty, accounting for age and gender.

Results

Of 2240 residents, 1230 completed the survey (55% response rate) with 1081 eligible for analysis. Respondent frailty levels were as follows: Not Frail = 67% (n = 720), Prefrail = 14% (n = 157), Mildly Frail = 11% (n = 123), Moderately–Severely Frail = 7% (n = 81). For individuals 85–89 years old, age was significantly associated with increased odds of frailty (OR = 3.40; 95% CI: 1.62–7.09; p = .001). After adjusting for age and gender, the odds of higher frailty were greater for individuals experiencing (a) pain, which interfered with usual activities (interferes sometimes OR = 3.17; 95% CI: 2.42–4.15; p ≤ .001; interferes all of the time OR = 10.18; 95% CI: 5.42–19.14; p ≤ .001), or (b) feelings of loneliness (OR = 2.55; 95% CI: 1.80–3.62; p ≤ .001). For Not Frail or Prefrail persons, a recent fall incident was associated with enhanced odds of frailty (OR = 2.60; 95% CI: 1.69–3.98; p ≤ .001).

Conclusions

This cohort of older adults living in Australian retirement villages had greater odds of frailty if experiencing pain, loneliness or falls. Addressing these risk factors could reduce or delay progression to frailty and optimise positive ageing in this population.