Prevalence of frailty and its association with sociodemographic and clinical characteristics, and resource utilization in a population of Singaporean older adults

Aim: The present study examined the prevalence of frailty and its association with sociodemographic, clinical and social characteristics, and service utilization in a representative general population sample of Singaporean older adults.

Methods: A single-phase, cross-sectional survey was carried out in a nationally representative sample of 2102 Singapore residents aged 60 years and older. Five frailty parameters (weakness, slowness, exhaustion, low physical activity and/or unintentional weight loss) were measured to assess Fried's frailty phenotype to identify frail (meeting 3/5 criteria), prefrail (meeting 1 or 2 criteria) and non-frail (absence of all 5) older adults. On testing independent associations, multiple backward stepwise logistic regression analyses were carried out to identify the strongest correlates of frail states.

Results: The prevalence of frailty among the older adult population was found to be 5.7%. Sociodemographic, clinical and social characteristics differed significantly at an independent level by frailty status. A higher proportion of frail older adults had care needs (54.5%) compared to pre-frail (13.5%) and non-frail (2.2%), and poor social networks (58.8% vs prefrail [36.6%] and non-frail [28.6%]). Frail older adults also had significantly higher service utilization. Significant correlates of frail state were older age, poor social networks, having any care need, and a history of dementia, diabetes, cancer, respiratory problems or paralysis.

Conclusions: Frailty is common among older adults in Singapore, and it correlates with many components at the person, health and societal levels, thus highlighting the importance of individual- and population-level frailty detection and interventions in this population. Geriatr Gerontol Int 2017; 17: 1444-1454.