title: Socioeconomic status is associated with frailty: the Women's Health and Aging Studies.
abstract: BACKGROUND
  Frailty is a common risk factor for morbidity and mortality in older adults. Although both low socioeconomic status (SES) and frailty are important sources of vulnerability, there is limited research examining their relationship. A study was undertaken to determine (1) the extent to which low SES was associated with increased odds of frailty and (2) whether race was associated with frailty, independent of SES.
  
  
  METHODS
  A cross-sectional analysis of the Women's Health and Aging Studies using multivariable ordinal logistic regression modelling was conducted to estimate the relationship between SES measures and frailty status in 727 older women. Control variables included race, age, smoking status, insurance status and co-morbidities.
  
  
  RESULTS
  Of the sample, 10% were frail, 46% were intermediately frail and 44% were robust. In adjusted models, older women with less than a high school degree had a threefold greater odds of frailty compared with more educated individuals. Those with an annual income of less than $10 000 had two times greater odds of frailty than wealthier individuals. These findings were independent of age, race, health insurance status, co-morbidity and smoking status. African-Americans were more likely to be frail than Caucasians (p<0.01). However, after adjusting for education, race was not associated with frailty. The effect of race was confounded by socioeconomic position.
  
  
  CONCLUSIONS
  In this population-based sample, the odds of frailty were increased for those of low education or income regardless of race. The growing population of older adults with low levels of education and income renders these findings important.
authors.affiliation: Johns Hopkins University Center on Aging and Health, 525 N. Wolfe Street, Baltimore, MD 21205 424, USA. sszanton@son.jhmi.edu
authors.forename: S L
authors.initials: SL
authors.lastname: Szanton
authors.forename: C L
authors.initials: CL
authors.lastname: Seplaki
authors.forename: R J
authors.initials: RJ
authors.lastname: Thorpe
authors.forename: J K
authors.initials: JK
authors.lastname: Allen
authors.forename: L P
authors.initials: LP
authors.lastname: Fried
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D015995:Prevalence; D012307:Risk Factors; D012923:Social Class; D044465:White People
references.citation: Eur J Epidemiol. 2007;22(1):55-66
references.pmid: 17225957
references.citation: Arch Intern Med. 2008 Feb 25;168(4):382-9
references.pmid: 18299493
references.citation: BMC Public Health. 2007 Aug 17;7:212
references.pmid: 17705867
references.citation: Ann Epidemiol. 2006 Feb;16(2):91-104
references.pmid: 16257232
references.citation: Eur Heart J. 2002 Nov;23(22):1757-63
references.pmid: 12419295
references.citation: Arch Intern Med. 2007 Apr 9;167(7):635-41
references.pmid: 17420420
references.citation: Annu Rev Psychol. 1997;48:411-47
references.pmid: 9046565
references.citation: J Gerontol A Biol Sci Med Sci. 2006 Mar;61(3):262-6
references.pmid: 16567375
references.citation: Am J Public Health. 2006 May;96(5):826-33
references.pmid: 16380565
references.citation: Occup Environ Med. 2006 Jul;63(7):438-42
references.pmid: 16782827
references.citation: J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56
references.pmid: 11253156
references.citation: Ann Epidemiol. 2001 Aug;11(6):395-405
references.pmid: 11454499
references.citation: J Gerontol A Biol Sci Med Sci. 2000 Jan;55(1):M43-52
references.pmid: 10719772
references.citation: Brain Behav Immun. 2003 Aug;17(4):286-95
references.pmid: 12831831
references.citation: J Gerontol A Biol Sci Med Sci. 2007 Jul;62(7):744-51
references.pmid: 17634322
references.citation: Psychoneuroendocrinology. 2004 Jun;29(5):651-68
references.pmid: 15041087
references.citation: J Am Geriatr Soc. 2006 Jun;54(6):991-1001
references.pmid: 16776798
references.citation: J Gerontol B Psychol Sci Soc Sci. 2007 Jul;62(4):S209-17
references.pmid: 17673534
references.citation: J Gerontol A Biol Sci Med Sci. 2006 Jun;61(6):594-9
references.pmid: 16799142
references.citation: Med Care. 2006 Nov;44(11 Suppl 3):S10-6
references.pmid: 17060816
references.citation: J Am Geriatr Soc. 2007 Jun;55(6):864-71
references.pmid: 17537086
references.citation: Ann Epidemiol. 2006 Jul;16(7):545-53
references.pmid: 16388967
references.citation: JAMA. 2005 Dec 14;294(22):2879-88
references.pmid: 16352796
references.citation: Gerontology. 2005 Nov-Dec;51(6):402-8
references.pmid: 16299422
references.citation: Soc Sci Med. 2004 May;58(10):1985-97
references.pmid: 15020014
references.citation: J Gerontol A Biol Sci Med Sci. 2005 Jun;60(6):729-35
references.pmid: 15983175
references.citation: J Am Geriatr Soc. 2005 Aug;53(8):1321-30
references.pmid: 16078957
references.citation: J Chronic Dis. 1986;39(7):505-11
references.pmid: 3722314
references.citation: Am J Prev Med. 2008 Dec;35(6):561-7
references.pmid: 18842389
references.citation: Health Aff (Millwood). 2002 Mar-Apr;21(2):60-76
references.pmid: 11900187
references.citation: J Anat. 2006 Apr;208(4):433-43
references.pmid: 16637869
references.citation: Am J Public Health. 2004 Jun;94(6):1037-42
references.pmid: 15249312
references.citation: Int J Epidemiol. 2004 Apr;33(2):398-407
references.pmid: 15082648
references.citation: J Health Soc Behav. 2006 Mar;47(1):17-31
references.pmid: 16583773