Neighborhood deprivation, individual socioeconomic status, and frailty in older adults.
OBJECTIVE
To assess how individual socioeconomic status and neighborhood deprivation affect frailty.


METHODS
Nationally representative population-based study, the English Longitudinal Study of Aging (ELSA), analyzed cross-sectionally.


METHODS
Four thousand eight hundred eighteen individuals aged 65 and older.


METHODS
Outcome was a frailty index (FI), based on 58 potential deficits, with a theoretical range from 0 to 1; exposures were individual wealth and neighborhood deprivation (lack of local resources, financial and otherwise), based on a set of standard indicators.


RESULTS
The FI score varied independently according to wealth and neighborhood deprivation. The mean FI score for an individual in the highest 20% of wealth and least deprived 20% of neighborhoods was 0.09 (95% confidence interval (CI)=0.09-0.09) and for an individual in the lowest 20% of wealth and most deprived 20% of neighborhoods was 0.17 (95% CI=0.16-0.17).


CONCLUSIONS
Frailty in older adults is independently associated with individual and neighborhood socioeconomic factors. Older adults who are poor and live in deprived neighborhoods are most vulnerable. Policies and interventions intended to prevent or reduce frailty must take into account individual circumstances and the broader social settings in which individuals are located.
Lang
Iain A
IA
Epidemiology and Public Health Group, Peninsula Medical School, Exeter, England. iain.lang@pms.ac.uk
Hubbard
Ruth E
RE
Andrew
Melissa K
MK
Llewellyn
David J
DJ
Melzer
David
D
Rockwood
Kenneth
K
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008297:Male; D012111:Residence Characteristics; D012934:Social Isolation; D012959:Socioeconomic Factors