The relationship between deprivation and frailty trajectories over 1 year and at the end of life: A case-control study

Stow, Daniel; Hanratty, Barbara; Matthews, Fiona E.

Abstract

Background: We investigated the association between area-level, multi-domain deprivation and frailty trajectories in the last year of life and over 1 year in a matched non-end-of-life sample. Methods: A 1-year longitudinal case-control study using primary care electronic health records from 20 460 people age ≥ 75. Cases (died 1 January 2015 to 1 January 2016) were 1:1 matched to controls by age, sex and practice location. Monthly interval frailty measured using a 36-item electronic frailty index (eFI: range 0-1, lower scores mean less frailty). Deprivation measured using Index of Multiple Deprivation (IMD) quintiles. We used latent growth curves to model the relationship between IMD and eFI trajectory. Results: Living in a less deprived area was associated with faster increase in eFI for cases (0.005% per month, 95%confidence interval [CI]: 0.001, 0.010), but not controls, and was associated with lower eFI at study baseline in cases (-0.29% per IMD quintile, 95%CI -0.45, -0.13) and controls (-0.35% per quintile, 95%CI -0.51, -0.20). Conclusions: Overall, greater area-level deprivation is associated with higher levels of frailty, but people who survive to ≥75 have similar 1-year frailty trajectories, regardless of area-level deprivation. Interventions to reduce frailty should target younger age groups, especially those living in the most deprived areas.

Citation

Stow, D., Hanratty, B., & Matthews, F. E. (2022). The relationship between deprivation and frailty trajectories over 1 year and at the end of life: A case-control study. Journal of Public Health, 44(4), 844-850. https://doi.org/10.1093/pubmed/fdab320

• Journal Article Type: Article
• Acceptance Date: Jul 12, 2021
• Online Publication Date: Sep 20, 2021
• Publication Date: Dec 1, 2022
• Deposit Date: Mar 29, 2024
• Publicly Available Date: Apr 3, 2024
• Journal: Journal of Public Health (United Kingdom)
• Print ISSN: 1741-3842
• Electronic ISSN: 1741-3850
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 44
• Issue: 4
• Pages: 844-850
• DOI: https://doi.org/10.1093/pubmed/fdab320
• Keywords: Deprivation; Frailty; Longitudinal; Socio-economic-status; Trajectories
• Public URL: https://hull-repository.worktribe.com/output/4496429