Socioeconomic inequalities in frailty among older adults in six low- and middle-income countries: Results from the WHO Study on global AGEing and adult health (SAGE)
Por:
Hoogendijk E.O., Rijnhart J.J.M., Kowal P., Pérez-Zepeda M.U., Cesari M., Abizanda P., Flores Ruano T., Schop-Etman A., Huisman M., Dent E.
Publicada:
1 ene 2018
Resumen:
Objectives: The aim of this study was to investigate socioeconomic inequalities in frailty among older adults in six low- and middle-income countries (LMICs), and to examine to what extent chronic diseases account for these inequalities. Study design: Data were used from the Study on global AGEing and adult health (SAGE) wave 1 (2007–2010). Nationally representative samples of adults aged 50+ years from China, Ghana, India, Mexico, the Russian Federation and South Africa were analyzed (n = 31,174). Main outcome measures: Educational level and wealth were used as socioeconomic indicators. Frailty was assessed with modified criteria for the frailty phenotype. Self-reported disease diagnoses were used. A relative index of inequality (RII) was calculated to compare socioeconomic inequalities in frailty between countries. Results: People in lower socioeconomic positions had higher prevalence rates of frailty. The largest inequalities in frailty were found in Mexico (RII 3.7, 95% CI 2.1–6.4), and the smallest inequalities in Ghana (RII 1.1, 95% CI 0.7–1.8). Mediation analyses revealed that the chronic diseases considered in this study do not explain the higher prevalence of frailty seen in lower socioeconomic groups. Conclusions: Substantial socioeconomic inequalities in frailty were observed in LMICs, but additional research is needed to find explanations for these. Given that the population of older adults in many LMICs is expanding at a greater rate than in many high-income countries, our results indicate an urgent public health need to address frailty in these countries. © 2018 Elsevier B.V.
Filiaciones:
Hoogendijk E.O.:
Department of Epidemiology & Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, Netherlands
Rijnhart J.J.M.:
Department of Epidemiology & Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, Netherlands
Kowal P.:
Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
World Health Organization, Geneva, Switzerland
Pérez-Zepeda M.U.:
Clinical and Epidemiologic Research Department, Instituto Nacional de Geriatría, Mexico City, Mexico
Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
Cesari M.:
Geriatric Unit, Fondazione Ca’ Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
Abizanda P.:
Department of Geriatrics, Albacete University Hospital, Albacete, Spain
Flores Ruano T.:
Department of Geriatrics, Albacete University Hospital, Albacete, Spain
Schop-Etman A.:
Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
Erasmus University College, Erasmus University, Rotterdam, Netherlands
Huisman M.:
Department of Epidemiology & Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, Netherlands
Department of Sociology, VU University, Amsterdam, Netherlands
Dent E.:
Torrens University Australia, Adelaide, Australia
Baker Heart and Diabetes Institute, Melbourne, Australia
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