Factors associated with short term transitions in frailty status in the population ≥ 50 years of age

Background Frailty is a clinical state that increases an individual's vulnerability and leads to chronic and complex medical needs in the older population. Transition to frailty is a dynamic and reversible process. Therefore, identification of determinants of transitions between frailty states is important for preventive action. This study assesses correlates of short time transitions in frailty states in the non-institutionalized population aged ≥ 50 years in Belgium. Methods 404 respondents of the Belgian health interview survey 2018 belonging to the target age group participated in a subsequent health examination survey (average time lapse 53 days). At both time points frailty was assessed with the SHARE frailty instrument classifying respondents as robust, prefrail or frail according to Fried's phenotype. Physical, biomedical, mental, social and demographic determinants of transitions in frailty status were explored through relative risk ratios (RRR) from a backward stepwise multinomial regression analysis. Results Both upward and downward transitions occurred in 21% of the respondents. Transitions were more frequent in women. Being obese (RRR 1.93; 95%CI 1.02-3.67) and being unsatisfied with social contacts (RRR 4.35; 95%CI 1.59-11.86) were significantly associated with a transition to a less favorable frailty status. Activity limitations (RRR 0.30; 95%CI 0.13-0.68) and a high serum total/HDL-cholesterol ratio (RRR 0.19; 95%CI 0.04-0.79) were inversely associated with an improvement of the frailty status. No significant associations were found with age, education level, multimorbidity, mental health, quality of life, smoking, physical activity, hyperglycemia, hypertension and increased C-reactive protein. Conclusions Preventive action to delay or reverse the transition towards frailty should start from 50 years onwards and include nutritional advise, actions that facilitate people to participate in activities and initiatives to improve social networks of people. Key messages Obesity and a high serum total/HDL-cholesterol ratio are risk factors for developing frailty. Investing in a good social network and an environment which facilitates participation in activities is important to delay or reverse the evolution towards frailty.