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Minimum income for healthy living and frailty in adults over 65 years old in the English Longitudinal Study of Ageing: a population-based cohort study.

ABSTRACT: OBJECTIVE:To test whether minimum income for healthy living of a person aged 65 years or older (MIHL65) is associated with frailty in older adults. DESIGN AND SETTING:Secondary analysis of the English Longitudinal Study of Ageing, a multiwave prospective cohort study in England, UK. PARTICIPANTS:A subset (n=1342) of English Longitudinal Study of Ageing participants, who at wave 1 in 2002 were aged 65 years or older, without any limiting long-standing illnesses, and who had the information required to calculate MIHL65 in 2002, 2004 and 2006 and two measures of frailty in 2008. MAIN OUTCOME MEASURES:Frailty defined using Fried's phenotype criteria and Rockwood's Index of deficits. RESULTS:The odds of frailty in 2008 were significantly higher for participants living below MIHL65 in 2002, both on Fried's phenotype criteria (OR 2.56, 95% CI 1.57 to 4.19) and Rockwood's Index (OR 2.83, 95%?CI 1.74 to 4.60). These associations remained after adjustment for age and gender for both Fried's phenotype (OR 1.85, 95%?CI 1.18 to 2.90) and Rockwood's Index (OR 2.15, 95%?CI 1.38 to 3.35). Compared with those whose income during 2002-2006 was always above MIHL65, the odds of frailty in 2008 for those below MIHL65 were two-to-three times higher, with a tendency for the ORs to increase in line with the length of time spent below MIHL65 (ORs (95% CIs) were: Fried's phenotype, below MIHL65 once: 2.02 (1.23 to 3.34); twice: 2.52 (1.37 to 4.62); thrice: 3.53 (1.65 to 7.55). Rockwood's Index: once: 2.34 (1.41 to 3.86); twice: 3.06 (1.64 to 5.71); thrice: 2.56 (1.22 to 5.34)). These associations remained after adjustment for age and gender on Rockwood's Index, but not Fried's phenotype. CONCLUSIONS:These results provide some support for the idea that frailty at older ages is associated with not having sufficient income to lead a healthy life.

SUBMITTER: Watts PN

PROVIDER: S-EPMC6398705 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Minimum income for healthy living and frailty in adults over 65 years old in the English Longitudinal Study of Ageing: a population-based cohort study.

Watts Paul Nicholas PN Blane David D Netuveli Gopalakrishnan G

BMJ open 20190227 2

<h4>Objective</h4>To test whether minimum income for healthy living of a person aged 65 years or older (MIHL<sub>65</sub>) is associated with frailty in older adults.<h4>Design and setting</h4>Secondary analysis of the English Longitudinal Study of Ageing, a multiwave prospective cohort study in England, UK.<h4>Participants</h4>A subset (n=1342) of English Longitudinal Study of Ageing participants, who at wave 1 in 2002 were aged 65 years or older, without any limiting long-standing illnesses, a ...[more]

PMID: 30819709

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Project description:BackgroundPain has been suggested to act as a stressor during aging, potentially accelerating declines in health and functioning. Our objective was to examine the longitudinal association between self-reported pain and the development, or worsening, of frailty among older men and women.MethodsThe study population consisted of 5,316 men and women living in private households in England, mean age 64.5 years, participating in the English Longitudinal Study of Ageing (ELSA). Data from Waves 2 and 6 of ELSA were used in this study with 8 years of follow-up. At Wave 2, participants were asked whether they were "often troubled with pain" and for those who reported yes, further information regarding the intensity of their pain (mild, moderate, or severe) was collected. Socioeconomic status (SES) was assessed using information about the current/most recent occupation and also net wealth. A frailty index (FI) was generated, with the presence of frailty defined as an FI >0.35. Among those without frailty at Wave 2, the association between pain at Wave 2 and frailty at Wave 6 was examined using logistic regression. We investigated whether pain predicted change in FI between Waves 2 and 6 using a negative binomial regression model. For both models adjustments were made for age, gender, lifestyle factors, depressive symptoms, and socioeconomic factors.ResultsAt Wave 2, 455 (19.7%) men and 856 (28.7%) women reported they often experienced moderate or severe pain. Of the 5,159 participants who were nonfrail at Wave 2, 328 (6.4%) were frail by Wave 6. The mean FI was 0.11 (standard deviation [SD] = 0.1) at Wave 2 and 0.15 (SD = 0.1) at Wave 6. After adjustment for age, gender, body mass index, lifestyle factors, and depressive symptoms, compared to participants reporting no pain at Wave 2 those reporting moderate (odds ratio [OR] = 3.08, 95% confidence interval [CI] = 2.28, 4.16) or severe pain (OR = 3.78, 95% CI = 2.51, 5.71) were significantly more likely to be frail at Wave 6. This association persisted after further adjustment for either occupational class and/or net wealth level. Compared to those without pain, those with mild, moderate, or severe pain were also more likely to develop worsening frailty, as assessed using the FI, and this association persisted after adjustment for SES. There was no evidence that the association between pain and frailty was influenced by gender.ConclusionPain is associated with an increased risk and intensity of frailty in older men and women. Socioeconomic factors contribute to the occurrence of frailty; though in our study do not explain the relationship between pain and frailty.

Dataset Information

Minimum income for healthy living and frailty in adults over 65 years old in the English Longitudinal Study of Ageing: a population-based cohort study.

Publications

Minimum income for healthy living and frailty in adults over 65 years old in the English Longitudinal Study of Ageing: a population-based cohort study.

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