Dissecting the Racial/Ethnic Disparity in Frailty in a Nationally Representative Cohort Study with Respect to Health, Income, and Measurement.
Black or African American
/ statistics & numerical data
Aged
Body Mass Index
Cohort Studies
Cross-Sectional Studies
Female
Frailty
/ diagnosis
Health Status Disparities
Hispanic or Latino
/ statistics & numerical data
Humans
Income
Male
Phenotype
Prevalence
United States
White People
/ statistics & numerical data
Differential measurement
Epidemiology
Minority aging
Public health
Journal
The journals of gerontology. Series A, Biological sciences and medical sciences
ISSN: 1758-535X
Titre abrégé: J Gerontol A Biol Sci Med Sci
Pays: United States
ID NLM: 9502837
Informations de publication
Date de publication:
01 01 2021
01 01 2021
Historique:
received:
16
10
2019
pubmed:
10
3
2020
medline:
16
7
2021
entrez:
10
3
2020
Statut:
ppublish
Résumé
Racial/ethnic frailty prevalence disparities have been documented. Better elucidating how these operate may inform interventions to eliminate them. We aimed to determine whether physical frailty phenotype (PFP) prevalence disparities (i) are explained by health aspects, (ii) vary by income, or (iii) differ in degree across individual PFP criteria. Data came from the 2011 National Health and Aging Trends Study baseline evaluation. The study sample (n = 7,439) included persons in all residential settings except nursing homes. Logistic regression was used to achieve aims (i)-(iii) listed above. In (i), health aspects considered were body mass index (BMI) status and number of chronic diseases. Analyses incorporated sampling weights and adjusted for sociodemographic factors. Comparisons are versus non-Hispanic whites: Non-Hispanic blacks (odds ratio [OR] = 1.46, 95% confidence interval [CI]: 1.21-1.76) and Hispanics (1.56, 1.20-2.03) continued to have higher odds of frailty after accounting for BMI status and number of chronic diseases. Non-Hispanic blacks had elevated odds of frailty in all income quartiles, including the highest (OR = 2.19, 1.24-3.397). Racial/ethnic disparities differed considerably across frailty criteria, ranging from a twofold increase in odds of slowness to a 25%-30% decrease in odds of self-reported exhaustion. BMI and disease burden do not explain racial/ethnic frailty disparities. Black-white disparities are not restricted to low-income groups. Racial/ethnic differences vary considerably by NHATS PFP criteria. Our findings support the need to better understand mechanisms underlying elevated frailty burden in older non-Hispanic black and Hispanic Americans, how phenotypic measures capture frailty in racial/ethnic subgroups and, potentially, how to create assessments more comparable by race/ethnicity.
Sections du résumé
BACKGROUND
Racial/ethnic frailty prevalence disparities have been documented. Better elucidating how these operate may inform interventions to eliminate them. We aimed to determine whether physical frailty phenotype (PFP) prevalence disparities (i) are explained by health aspects, (ii) vary by income, or (iii) differ in degree across individual PFP criteria.
METHODS
Data came from the 2011 National Health and Aging Trends Study baseline evaluation. The study sample (n = 7,439) included persons in all residential settings except nursing homes. Logistic regression was used to achieve aims (i)-(iii) listed above. In (i), health aspects considered were body mass index (BMI) status and number of chronic diseases. Analyses incorporated sampling weights and adjusted for sociodemographic factors.
RESULTS
Comparisons are versus non-Hispanic whites: Non-Hispanic blacks (odds ratio [OR] = 1.46, 95% confidence interval [CI]: 1.21-1.76) and Hispanics (1.56, 1.20-2.03) continued to have higher odds of frailty after accounting for BMI status and number of chronic diseases. Non-Hispanic blacks had elevated odds of frailty in all income quartiles, including the highest (OR = 2.19, 1.24-3.397). Racial/ethnic disparities differed considerably across frailty criteria, ranging from a twofold increase in odds of slowness to a 25%-30% decrease in odds of self-reported exhaustion.
CONCLUSIONS
BMI and disease burden do not explain racial/ethnic frailty disparities. Black-white disparities are not restricted to low-income groups. Racial/ethnic differences vary considerably by NHATS PFP criteria. Our findings support the need to better understand mechanisms underlying elevated frailty burden in older non-Hispanic black and Hispanic Americans, how phenotypic measures capture frailty in racial/ethnic subgroups and, potentially, how to create assessments more comparable by race/ethnicity.
Identifiants
pubmed: 32147727
pii: 5799267
doi: 10.1093/gerona/glaa061
pmc: PMC7756712
doi:
Types de publication
Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
69-76Subventions
Organisme : NIA NIH HHS
ID : K01 AG054751
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG021334
Pays : United States
Organisme : NIA NIH HHS
ID : U01 AG032947
Pays : United States
Organisme : NIA NIH HHS
ID : T32 AG000247
Pays : United States
Organisme : NIMHD NIH HHS
ID : U54 MD000214
Pays : United States
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Références
Aging (Albany NY). 2019 Aug 8;11(15):5518-5534
pubmed: 31395793
Stat Med. 2011 Feb 20;30(4):377-99
pubmed: 21225900
J Ambul Care Manage. 2008 Apr-Jun;31(2):161-77
pubmed: 18360178
J Gerontol A Biol Sci Med Sci. 2015 Nov;70(11):1427-34
pubmed: 26297656
Health Care Financ Rev. 2000 Summer;21(4):75-90
pubmed: 11481746
Ann Epidemiol. 2006 Jul;16(7):545-53
pubmed: 16388967
J Gerontol B Psychol Sci Soc Sci. 2020 Feb 14;75(3):650-660
pubmed: 29878196
J Am Med Dir Assoc. 2016 Apr 1;17(4):372.e1-3
pubmed: 26837597
J Am Geriatr Soc. 2005 Jun;53(6):927-34
pubmed: 15935013
Aging Clin Exp Res. 2017 Aug;29(4):721-728
pubmed: 27568018
J Gerontol A Biol Sci Med Sci. 2004 Mar;59(3):255-63
pubmed: 15031310
J Epidemiol Community Health. 2010 Jan;64(1):63-7
pubmed: 19692719
J Aging Health. 2017 Mar;29(2):289-309
pubmed: 26965083
J Gerontol B Psychol Sci Soc Sci. 2002 Sep;57(5):S275-84
pubmed: 12198107
J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56
pubmed: 11253156
J Am Geriatr Soc. 2016 Apr;64(4):908-11
pubmed: 27100601
J Frailty Aging. 2014;3(2):120-5
pubmed: 27049905
J Am Geriatr Soc. 2008 Sep;56(9):1744-9
pubmed: 18662198
J Am Geriatr Soc. 2018 Mar;66(3):559-564
pubmed: 29168883
Health Aff (Millwood). 2012 Aug;31(8):1803-13
pubmed: 22869659