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Background Little is known about to what extent neighbourhood built and social environmental factors are associated with frailty among community-dwelling mid-to-older aged adults. Methods Participants of our cross-sectional study were adults aged 50-74 years residing in Brisbane, Australia. Frailty was assessed by a frailty index (FI), consisting of 32 items. Five built environmental attributes (population density, density of 4-way intersections, area of retail land, area of park land, and area of land for recreational facilities) and three social environmental attributes (safety, cohesion, and socio-economic status [SES]) were included. We performed multilevel logistic regression analysis to examine the associations between those attributes and frailty. Results Of 4,176 eligible participants (56.8% women), we found that 437 (10.5%) were frail (FI ≥ 0.35). After adjusting for potential confounders, one standard deviation (SD) increment in intersection density and retail land area was associated 26% (95%CI: 1.12, 1.41) and 18% (95%CI: 1.07, 1.30) higher odds of being frail, respectively. One SD increment in safety and area-level SES was associated with 24% (95%CI: 0.69, 0.84) and 30% (95%CI: 0.62, 0.79) lower odds of being frail. Conclusions This study found that mid-to-older aged adults with frailty are more likely to live in areas with higher intersection density, greater area of retail land, poorer safety, and higher levels of deprivation. Key messages There is spatial heterogeneity in the distribution of frailty. Future research should investigate behavioural mechanism for the distribution.

317Neighbourhood built and social environmental attributes associated with frailty among mid-to-older aged Australian adults