Temporal trends in the prevalence of frailty in England from 2002 to 2022, with forecasts to 2040: longitudinal secondary analysis of a national cohort study
ABSTRACT
Background:
The increasing life expectancy provides an opportunity for healthy longevity, but frailty is a potential challenge.
Objective:
This study aimed to explore temporal trends of frailty prevalence and project future changes for the middle-aged and older community-dwelling population in England.
Methods:
: Prevalence of frailty (measured using a frailty index) in the overall sample and subgroups of age, sex, education, and marital status from 2002 to 2022 were estimated among adults aged 50 years and above using ten waves of nationally representative data from English Longitudinal Study of Ageing (N = 6226 to 11 218 across waves). The number of frail individuals was also derived in each year. Joinpoint regression models were used to explore temporal trends of frailty prevalence. A linear probability regression model was performed to explore driving factors and project future prevalence.
Results:
A statistically non-significant increase of 2·3 percentage points from 15·5% in 2002 to 17·8% in 2022 was observed, with the number of frail individuals growing from 2 560 122 to 3 791 038 among adults aged 50 years and older in England. Those with advanced age, who were female, with lower education level and/or single had consistently higher prevalence of frailty. The overall change in frailty prevalence reflected the net result of opposing contributions from different factors, with improvements in socio-demographic conditions and education attainment andhealthier lifestyle behaviours offsetting 222·5%, 94·9%, and 51·6% of the observed increase, respectively. By 2040, 5 213 689 middle-aged and older people in England will live with frailty, with a projected prevalence of 20·5%.
Conclusions:
Despite a modest increase in prevalence, the substantial growth in the absolute number of frail individuals indicates a likely rise in future care demands. An intervention framework for future public health policy needs developing, focusing on enhancing educational attainment and promoting healthy lifestyles.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.