Prevalence and incidence of frailty among community-dwelling older adults in Slovenia

Janja Jazbar; Špela Pišek; Igor Locatelli; Mitja Kos

doi:10.2478/sjph-2021-0027

Figures & Tables

Age-standardized prevalence of pre-frailty (A) and frailty (B) across Slovenian geographical regions.

The prevalence of pre-frailty and frailty in Slovenia and Europe_

Variable	Sample size^a		Pre-frailty Prevalence % (95% CI)		Frailty Prevalence % (95% CI)

	Slovenia	Europe	Slovenia	Europe	Slovenia	Europe
Overall	2,286	37,471	41.8 (39.8-43.8)	44.4 (43.6-45.2)	14.2 (12.7-15.6)	15.4 (14.8-15.9)
Gender
Male	990	16,833	38.2 (35.2-41.2)	42.2 (41.5-42.9)	11.8 (9.8-13.8)	12.0 (11.5-12.5)
Female	1,296	20,638	44.6 (41.9-47.3)	46.2 (45.6-46.9)	16.0 (14.0-18.0)	18.1 (17.6-18.6)
Age group
65-74 years	1,300	21,006	38.5 (35.8-41.1)	41.5 (40.9-42.2)	6.4 (5.1-7.7)	8.2 (7.8-8.6)
75-84 years	770	12,834	45.8 (42.3-49.4)	48.5 (47.7-49.4)	22.2 (19.3-25.1)	20.3 (19.6-21.0)
≥85 years	216	3,631	47.7 (41.0-54.3)	46.5 (44.9-48.2)	32.4 (26.2-38.6)	39.6 (38.0-41.2)
Highest educational level
primary	863	17,371	48.1 (44.8-51.4)	47.5 (46.8-48.3)	21.3 (18.6-24.1)	21.4 (20.8-22.0)
secondary	1,076	12,258	39.7 (36.8-42.6)	42.7 (41.8-43.5)	11.0 (9.1-12.8)	11.0 (10.5-11.6)
tertiary	341	7,228	32.8 (27.9-37.8)	40.1 (39.0-41.3)	6.5 (3.8-9.1)	7.8 (7.2-8.4)
Self-rated health
excellent	58	1,828	20.7 (10.3-31.1)	24.7 (22.7-26.6)	/^b	1.4 (0.9-2.0)
very good	148	5,237	22.3 (18.2-26.4)	30.4 (29.1-31.6)	/^b	1.9 (1.5-2.2)
good	954	13,332	34.8 (31.8-37.8)	43.9 (43.1-44.8)	4.0 (2.7-5.2)	5.6 (5.2-6.0)
fair	723	12,459	54.1 (50.4-57.7)	54.7 (53.8-55.6)	13.8 (11.3-16.3)	19.8 (19.1-20.5)
poor	402	4,604	46.5 (41.6-51.4)	41.8 (40.3-43.2)	46.3 (41.4-51.1)	52.6 (51.2-54.1)
Polypharmacy
no	1,524	21,620	41.6 (39.1-44.1)	45.3 (44.7-46.0)	10.1 (8.6-11.6)	10.4 (10.0-10.8)
yes	477	10,442	48.2 (43.7-52.7)	48.4 (47.4-49.3)	32.9 (28.7-37.1)	32.0 (31.1-32.9)
Number of chronic diseases
0-1	903	15,506	35.1 (32.0-38.2)	38.9 (38.1-39.7)	7.6 (5.9-9.3)	7.1 (6.7-7.5)
≥2	1,381	21,949	46.2 (43.6-48.8)	48.3 (47.6-49.0)	18.4 (16.4-20.4)	21.2 (20.7-21.7)

Factors associated with pre-frailty and frailty in Slovenia and Europe_

Variable	Pre-frailty		Frailty

	Slovenia	Europe	Slovenia	Europe

	Adjusted OR^a (95% CI)	Adjusted OR^b (95% CI)	Adjusted OR^a (95% CI)	Adjusted OR^b (95% CI)
Gender
Male	reference	reference	reference	reference
Female	1.46 (1.16-1.85)*	1.36 (1.29-1.43)*	1.39 (0.89-2.19)	1.79 (1.61-1.97)*

Age group
65-74 years	reference	reference	reference	reference
75-84 years	1.65 (1.28-2.12)*	1.60 (1.51-1.69)*	5.03 (3.08-8.22)*	3.07 (2.76-3.40)*
≥85 years	3.06 (1.93-4.85)*	3.41 (3.03-3.84)*	21.7 (10.6-44.7)*	15.9 (13.5-18.8)*

Highest educational level
primary	reference	reference	reference	reference
secondary	0.71 (0.55-0.91)*	0.83 (0.77-0.88)*	0.88 (0.54-1.43)	0.67 (0.59-0.75)*
tertiary	0.51 (0.35-0.73)*	0.76 (0.70-0.82)*	0.92 (0.45-1.89)	0.52 (0.45-0.60)*

Self-rated health
excellent/very good/good	reference	reference	reference	reference
fair	2.47 (1.93-3.16)*	2.34 (2.20-2.49)*	4.58 (2.75-7.61)*	6.12 (5.47-6.85)*
poor	7.63 (4.75-12.26)*	6.57 (5.68-7.60)*	54.6 (28.1-105.9)*	62.6 (52.3-74.9)*

Polypharmacy
no	reference	reference	reference	reference
yes	1.72 (1.23-2.40)*	1.58 (1.47-1.69)*	3.25 (1.93-5.48)*	2.89 (2.59-3.22)*

Number of chronic diseases	1.14 (1.04-1.25)*	1.13 (1.11-1.15)*	1.20 (1.03-1.40)^#	1.22 (1.18-1.26)*

Age-standardized prevalence of pre-frailty and frailty across geographical regions in Slovenia_ The regions are listed from the lowest to the highest prevalence of frailty_

Slovenian region	Age-standardized prevalence of Frailty (95% CI)	Age-standardized prevalence of Pre-frailty (95% CI)
Gorenjska/Upper Carniola	8.5 (4.6-12.4)	38.7 (30.3-47.1)
Zasavska/Central Sava	10.0 (3.1-16.8)	32.9 (19.7-46.1)
Osrednjeslovenska/ Central Slovenia	10.3 (7.2-13.3)	39.8 (34.1-45.5)
Jugovzhodna Slovenija/ Southeast Slovenia	11.6 (6.3-17.0)	44.3 (33.5-55.0)
Notranjsko-kraška/ Littoral-Inner Carniola	12.0 (4.1-19.8)	35.3 (20.2-50.4)
Spodnjeposavska/ Lower Sava	13.3 (6.3-20.3)	49.2 (35.4-62.9)
Obalno-kraška/ Coastal-Karst	14.8 (8.2-21.5)	40.6 (29.0-52.2)
Goriška Gorizia	17.0 (10.0-23.9)	44.2 (33.1-55.3)
Savinjska/Savinja	19.5 (13.8-25.2)	44.6 (36.1-53.1)
Koroška/Carinthia	21.3 (12.2-30.4)	43.2 (31.4-55.1)
Podravska/Drava	22.7 (16.9-28.4)	41.7 (34.3-49.1)
Pomurska/Mura	27.0 (16.6-37.4)	46.9 (34.8-58.9)
Average	14.9 (13.3-16.5)	42.5 (39.8-45.2)

The incidence of pre-frailty and frailty in Slovenia and Europe_

Variable	Sample size*		Pre-frailty Prevalence % (95% CI)		Frailty Prevalence % (95% CI)

	Slovenia	Europe	Slovenia	Europe	Slovenia	Europe
Total	294	6902	37.8 (32.3-43.3)	39.2 (38.0-40.4)	4.4 (2.1-6.7)	5.4 (4.9-5.9)
Gender
Male	141	3426	30.5 (22.9-38.1)	36.2 (34.6-37.8)	5.0 (1.4-8.5)	4.9 (4.2-5.7)
Female	153	3476	44.4 (36.6-52.3)	42.3 (40.6-43.9)	3.9 (0.8-7.0)	6.0 (5.2-6.7)
Age group
65-74 years	209	5031	36.4 (29.8-42.9)	35.8 (34.5-37.1)	1.9 (0.1-3.8)	3.4 (2.9-3.9)
75-84 years	79	1716	40.5 (29.7-51.3)	48.3 (45.9-50.6)	10.1 (3.5-16.8)	9.9 (8.5-11.3)
≥85 years	6	155	50.0 (10.0-90.0)	52.3 (44.4-60.1)	16.7 (0.0-46.5)	22.6 (16-29.2)
Highest educational level
primary	77	2646	51.9 (40.8-63.1)	44.0 (42.1-45.9)	6.5 (1.0-12.0)	7.8 (6.8-8.8)
secondary	146	2540	36.3 (28.5-44.1)	36.3 (34.5-38.2)	3.4 (0.5-6.4)	4.1 (3.4-4.9)
tertiary	70	1571	24.3 (14.2-34.3)	35.3 (32.9-37.6)	4.3 (0.0-9.0)	3.4 (2.5-4.3)
Self-rated health
excellent	23	650	30.4 (11.6-49.2)	24.2 (20.9-27.4)	4.3 (0.0-12.7)	1.5 (0.6-2.5)
very good	57	1529	35.1 (22.7-47.5)	33.2 (30.9-35.6)	3.5 (0.0-8.3)	2.8 (2.0-3.6)
good	129	2942	40.3 (31.8-48.8)	38.9 (37.2-40.7)	1.6 (0.0-3.7)	4.6 (3.8-5.3)
fair	76	1628	35.5 (24.8-46.3)	49.8 (47.4-52.2)	9.2 (2.7-15.7)	9.9 (8.4-11.3)
poor	9	149	55.6 (23.1-88.0)	57.7 (49.8-65.7)	11.1 (0.0-31.6)	18.1 (11.9-24.3)
Number of chronic diseases
0-1	167	3742	37.1 (29.8-44.4)	36.0 (33.5-36.5)	4.2 (1.2-7.2)	4.0 (3.4-4.6)
≥2	127	3160	38.6 (30.1-47.1)	44.2 (42.5-45.9)	4.7 (1.0-8.4)	7.2 (6.3-8.1)

Variables used to define Frailty phenotype from SHARE data

Frailty phenotype defined by SHARE survey data

Shrinking: What has your appetite been like in the last month? No diminution in desire for food=0; Diminution in desire for food=1. If an uncodable response: “So, have you been eating more or less than usual?” More=0; Neither more nor less=0; Less=1

Weakness: Handgrip strength measured by dynamometer. Men (BMI≤24 and strength≤29=1; BMI 24.1–26 and strength≤30=1; BMI 26.1–28 and strength≤30=1; BMI>28 and strength≤32=1). Women (BMI≤23 and strength≤17=1; BMI 23.1–26 and strength≤17.3=1; BMI 26.1–29 and strength≤18=1; BMI>29 and strength≤21=1).

Exhaustion: In the last month, have you had too little energy to do the things you wanted to do? No=0; Yes=1

Slowness: Please tell me whether you have any difficulty [expected to last more than 3 months] walking 100 m or … climbing one flight of stairs without resting. No difficulties=0; Difficulty with either task=1

Low levels of physical activity: How often do you engage in activities that require moderate level of energy such as gardening, cleaning the car, or going for a walk? Once a week or more often=0; One to three times a month=1; Hardly ever, or never=1

Age-standardized prevalence of pre-frailty and frailty across European countries_ The countries are listed from the lowest to the highest prevalence of frailty_

Country	Age-standardized prevalence of Frailty (95% CI)	Age-standardized prevalence of Pre-frailty (95% CI)
Switzerland	6.8 (5.5-8.1)	41.0 (37.9-44.0)
Sweden	8.4 (7.3-9.5)	41.5 (39.1-43.9)
Denmark	10.3 (8.8-11.9)	38.2 (35.3-41)
Germany	11.4 (9.9-13)	39.9 (37.4-42.5)
Luxembourg	13.1 (10.3-16)	45.5 (40.5-50.6)
Czech Republic	14.8 (13.3-16.4)	43.6 (41.2-46)
Slovenia	14.9 (13.3-16.5)	42.5 (39.8-45.2)
Austria	15.4 (13.7-17.2)	36.9 (34.2-39.5)
Belgium	16.4 (15-17.9)	44.7 (42.3-47.2)
France	16.7 (15-18.4)	45.6 (42.8-48.5)
Estonia	17.7 (16.2-19.2)	53.1 (50.5-55.6)
Spain	18.7 (17.2-20.2)	47.2 (44.8-49.6)
Greece	20.2 (18.4-22)	47.7 (45-50.4)
Italy	21.7 (19.9-23.5)	48.3 (45.8-50.8)
Croatia	22.4 (19.4-25.4)	45.1 (41.2-49)
Portugal	27.1 (23.4-30.7)	45.5 (41.1-49.9)
Poland	27.5 (23.9-31.1)	48 (43.5-52.5)
Average	16.4 (16.0-16.8)	44.5 (43.9-45.2)