title: Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries.
abstract: BACKGROUND
  Frailty is an indicator of health status in old age. Its frequency has been described mainly for North America; comparable data from other countries are lacking. Here we report on the prevalence of frailty in 10 European countries included in a population-based survey.
  
  
  METHODS
  Cross-sectional analysis of 18,227 randomly selected community-dwelling individuals 50 years of age and older, enrolled in the Survey of Health, Aging and Retirement in Europe (SHARE) in 2004. Complete data for assessing a frailty phenotype (exhaustion, shrinking, weakness, slowness, and low physical activity) were available for 16,584 participants. Prevalences of frailty and prefrailty were estimated for individuals 50-64 years and 65 years of age and older from each country. The latter group was analyzed further after excluding disabled individuals. We estimated country effects in this subset using multivariate logistic regression models, controlling first for age, gender, and then demographics and education.
  
  
  RESULTS
  The proportion of frailty (three to five criteria) or prefrailty (one to two criteria) was higher in southern than in northern Europe. International differences in the prevalences of frailty and prefrailty for 65 years and older group persisted after excluding the disabled. Demographic characteristics did not account for international differences; however, education was associated with frailty. Controlling for education, age and gender diminished the effects of residing in Italy and Spain.
  
  
  CONCLUSIONS
  A higher prevalence of frailty in southern countries is consistent with previous findings of a north-south gradient for other health indicators in SHARE. Our data suggest that socioeconomic factors like education contribute to these differences in frailty and prefrailty.
authors.affiliation: Department of Community Medicine and Health, Institute of Social and Preventive Medicine, University Hospital Center and University of Lausanne, Switzerland. Brigitte.Santos-Eggimann@chuv.ch
authors.forename: Brigitte
authors.initials: B
authors.lastname: Santos-Eggimann
authors.forename: Patrick
authors.initials: P
authors.lastname: Cuénoud
authors.forename: Jacques
authors.initials: J
authors.lastname: Spagnoli
authors.forename: Julien
authors.initials: J
authors.lastname: Junod
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000453:epidemiology; D010809:Physical Fitness; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors