Identifying Frailty and its Outcomes in Older People in Rural Tanzania

Abstract

Background/Study Context: Interest in frailty is growing in low- and middle-income countries, due to demographic aging and resource limitations. However, there is a paucity of data on the nature of frailty in Africa.

Methods: The study collected frailty data from people aged 70 years and over living in six villages in the rural Hai District of northern Tanzania. At baseline, a limited data set was collected for 1198 people and a more comprehensive data set for a stratified sample of 296 people. A 40-item frailty index was constructed. Data regarding mortality and dependency were collected at 3-year follow-up.

Results: A higher frailty index score was significantly correlated with greater age, never having attended school, falls, mortality, and dependency in activities of daily living. Logistic regression modeling revealed functional disability and cognitive function to be significant independent predictors of the outcome “mortality or dependency.”

Conclusions: In resource-poor settings, brief frailty screening assessments may be a useful way of identifying those most in need of support.

ACKNOWLEDGMENTS

We wish to acknowledge the help of all health care workers, officials, carers, and family members who assisted in examination, assessment, data collection, and input. Victoria Ferguson (Northumbria Healthcare NHS Foundation Trust) is thanked for data entry and cleaning and Gillian Tough (Northumbria Healthcare NHS Foundation Trust) for administrative support.

FUNDING

This work was supported by a research fellowship from the Dunhill Medical Trust, the Royal College of Physicians, London, the Peel Medical Research Trust, a British Geriatrics Society SpR start-up grant, and an Academy of Medical Sciences (UK) clinical lecturer start-up grant. The sponsors of this study had no role in designing the study; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

Additional information

Funding

This work was supported by a research fellowship from the Dunhill Medical Trust, the Royal College of Physicians, London, the Peel Medical Research Trust, a British Geriatrics Society SpR start-up grant, and an Academy of Medical Sciences (UK) clinical lecturer start-up grant. The sponsors of this study had no role in designing the study; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.