ArticleJournal of urban health : bulletin of the New York Academy of Medicine2025
Neighborhood Socioeconomic Disadvantage and Frailty among Mid-to-Older-Aged Adults in Australia: Cross-Sectional and Longitudinal Associations.
Article in Journal of urban health : bulletin of the New York Academy of Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This study examined the cross-sectional and longitudinal associations between neighborhood socioeconomic disadvantage and frailty in middle-to-older-aged adults. Data were obtained from a cohort study conducted in Brisbane, Australia, with 3966 participants (mean age 58.2 years; female 57.6%) included in cross-sectional analysis and 2846 in longitudinal analysis (3-year follow-up). A frailty index (FI), a composite score consisting of 32 items, was used continuously (range 0-1) and categorized into frail (FI > 0.35) and non-frail. Neighborhood disadvantage was measured using the Index of Relative Socioeconomic Disadvantage, an area-level composite index, and was categorized into tertiles. Two-level mixed-effects linear and logistic regression models were fitted, accounting for area-level clustering through random intercepts for areas and adjusting for demographic variables and individual-level socioeconomic status. In the cross-sectional analysis, 11% of participants were frail. Compared to residents of low disadvantage neighborhoods, those in middle and high disadvantage neighborhoods had higher levels of frailty and greater odds of being frail (OR = 1.54 [95% CI 1.13, 2.09] and OR = 2.86 [2.11, 3.88], respectively). In the longitudinal analysis, residing in middle and high disadvantage neighborhoods was significantly associated with increases in FI scores, relative to low disadvantage neighborhoods. Incident frailty was observed in 5% of participants at the follow-up. Residing in high disadvantage neighborhoods showed significantly higher odds of incident frailty (OR = 1.75 [1.08, 2.86]). Mid-to-older-aged residents of disadvantaged neighborhoods are more likely to be frail and to become frail over 3 years, compared to those in advantaged neighborhoods. Community-level interventions to reduce frailty should target disadvantage neighborhoods.
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