Frailty before and during austerity: A time series analysis of the English Longitudinal Study of Ageing 2002-2018.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 21 06 2023
accepted: 04 12 2023
medline: 7 2 2024
pubmed: 7 2 2024
entrez: 7 2 2024
Statut: epublish

Résumé

Frailty is characterised by a reduced resilience to adversity. In this analysis we examined changes in frailty in people aged 50+ before and during a period of austere public spending in England. Data from the English Longitudinal Study of Ageing 2002-2018 were analysed. Associations between austerity and frailty were examined using (1) Multilevel interrupted times series analysis (ITSA); and (2) Accelerated longitudinal modelling comparing frailty trajectories in people of the same age in 2002 and 2012. The analysis included 16,410 people (mean age 67 years, 55% women), with mean frailty index score of 0.16. Mean scores in women (0.16) where higher than in men (mean 0.14), and higher in the poorest tertile (mean 0.20) than the richest (mean 0.12). In the ITSA, frailty index scores increased more quickly during austerity than before, with the additional increase in frailty 2012-2018 being similar in magnitude to the difference in mean frailty score between people aged 65-69 and 70-74 years. Steeper increases in frailty after 2012 were experienced across the wealth-spectrum and in both sexes but were greater in the very oldest (80+). In the accelerated longitudinal analysis, frailty was lower in 2012 than 2002, but increased more rapidly in the 2012 cohort compared to the 2002 cohort; markedly so in people aged 80+. The period of austerity politics was associated with steeper increases in frailty with age compared to the pre-austerity period, consistent with previously observed increases in mortality.

Sections du résumé

BACKGROUND BACKGROUND
Frailty is characterised by a reduced resilience to adversity. In this analysis we examined changes in frailty in people aged 50+ before and during a period of austere public spending in England.
METHODS METHODS
Data from the English Longitudinal Study of Ageing 2002-2018 were analysed. Associations between austerity and frailty were examined using (1) Multilevel interrupted times series analysis (ITSA); and (2) Accelerated longitudinal modelling comparing frailty trajectories in people of the same age in 2002 and 2012.
RESULTS RESULTS
The analysis included 16,410 people (mean age 67 years, 55% women), with mean frailty index score of 0.16. Mean scores in women (0.16) where higher than in men (mean 0.14), and higher in the poorest tertile (mean 0.20) than the richest (mean 0.12). In the ITSA, frailty index scores increased more quickly during austerity than before, with the additional increase in frailty 2012-2018 being similar in magnitude to the difference in mean frailty score between people aged 65-69 and 70-74 years. Steeper increases in frailty after 2012 were experienced across the wealth-spectrum and in both sexes but were greater in the very oldest (80+). In the accelerated longitudinal analysis, frailty was lower in 2012 than 2002, but increased more rapidly in the 2012 cohort compared to the 2002 cohort; markedly so in people aged 80+.
CONCLUSION CONCLUSIONS
The period of austerity politics was associated with steeper increases in frailty with age compared to the pre-austerity period, consistent with previously observed increases in mortality.

Identifiants

pubmed: 38324538
doi: 10.1371/journal.pone.0296014
pii: PONE-D-23-19168
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0296014

Informations de copyright

Copyright: © 2024 Pugh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Carys Pugh (C)

Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.

Chima Eke (C)

Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.

Sohan Seth (S)

Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.

Bruce Guthrie (B)

Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.

Alan Marshall (A)

Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.
School of Social and Political Science, University of Edinburgh, Edinburgh, United Kingdom.

Classifications MeSH