The impact of poverty transitions on frailty among older adults in South Korea: findings from the Korean longitudinal study of ageing

Abstract

Background: Frailty is an emerging public health concern among aging populations. Although socioeconomic status is a well-known contributor to frailty, there is limited research investigating the effects of poverty on frailty. This study aimed to examine the association between poverty transitions and frailty prevalence in older adults. Methods: Data were collected from the six-wave Korean Longitudinal Study of Ageing (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016). A total of 9263 middle-aged and older adults were included in the analysis. Poverty was defined as being below 50% of the median household income based on the equivalized household. Frailty was measured using an instrument comprising items on physical phenotype (grip strength) and psychological (exhaustion) and social aspects (isolation). Analyses using generalized estimating equations were conducted to estimate the relationship between poverty transition and frailty status. Results: Among the 9263 respondents, 9.4% of the male respondents (n = 388) and 13.6% of the female respondents (n = 700) were frail. After controlling for covariates, female participants who transitioned into poverty (OR = 1.31, 95% CI: 1.02-1.69) and persistently remained in poverty (OR = 1.36, 95% CI: 1.10-1.68) showed increased odds of frailty in the follow-up year. We did not find significant results in the male participants. Conclusions: The findings suggest that those who experience poverty transitions, enter poverty, and remain in poverty persistently are at higher risk of frailty. To improve age-related health status among the elderly, interventions aiming to prevent and reduce frailty among the elderly should target individuals who are more vulnerable to the negative effects of frailty.

The Association of Frailty with Poverty in Older Adults: A Systematic Review

“…Then, duplicates and other articles were excluded based on the eligibility criteria and the analysis of the abstracts and texts, resulting in 9 articles. There was consistency among the findings of the 9 studies (see Table 2) in terms of the relationship between socioeconomic factors and frailty among older adults [16][17][18][19][21][22][23][24][25], although there were variations in the ways that these studies had examined this relationship. These studies were cross-sectional and longitudinal studies.…”

“…One of the socioeconomic conditions known to contribute to the incidence of frailty is poverty [17,19]. Economic and financial circumstances, including poverty, can be considered a main social factor impacting health outcomes, as it corresponds to a range of risk factors, including sociodemographic and economic factors, that mainly affect people in rural areas.…”

“…It was noted that the level of frailty was higher among older adults with minimum income, getting in the way of fulfilling a healthy successful aging [18]. The older adults who get through poverty transitions, enter poverty, and live in poverty insistently are more prone to high level of frailty [19]. Thus, the investigation of the low income/poverty correlated with frailty is crucial to establish, promote, and drive the social and health policies tailored to combating the adverse health outcomes of poverty [17], such as frailty.…”

Frailty transitions and cognitive function among South Korean older adults

“…Frailty in older adults is linked to a greater risk of falls, hospitalization, disability, and death 1 , 2 . In Korea, reports indicate that the prevalence of frailty ranges from 2.5 to 31.7%, depending on the study sample and frailty scale measure 3 – 5 . Considering the significance and impact of frailty in the aging population, interest in and research regarding frailty has gradually increased 6 .…”

“…For this reason, we employed the frailty instrument (FI), a frailty measure developed and validated in the Korean population for rapid assessment of frailty and determination of negative health outcomes in older adults 3 , 11 . The FI encompassed a wider frailty approach, including items in the physical, psychological, and social domain 5 .…”