Frailty and Socioeconomic Status: A Paradoxical Relationship in North Dublin's Older Adult Population

Abstract Background Older adults from lower socioeconomic backgrounds are more likely to suffer adverse health outcomes and have higher incidences of frailty. We examined the association between socioeconomic deprivation and prevalence of frailty alongside corresponding outcomes among older adults living within the North Dublin region. Methods A retrospective cross-sectional logistic regression analysis of CGA data was performed on all older adults over 65 years who visited the Emergency Department from January - July 2023 and were assessed by the Frailty Intervention team (FIT). Characteristics reviewed included age, gender, marital status, living alone status, referrals to community services or rehabilitation, and distribution of frailty levels (CFS). Additionally, the Pobal HP Deprivation Index was utilised to assess affluence or disadvantage in the study population. Results The analysis included 1402 CGA recipients: 563 males and 839 females, with a female preponderance of 59.84%. The median age was 83.5 years. Frailty was categorised as fit (CFS 1), pre-frail (CFS 2-3), and frail (CFS 4+). A total of 562 older adult patients were classified as frail, with 31.32% residing in marginally above average areas compared to 0.53% in very affluent areas. Overall, 39.32% achieved admission avoidance with 32.17% from marginally above average areas. Following FIT review, 11.56% were referred to community services and 7.47% to off-site rehabilitation. The 90-day mortality rate was highest, 26.67%, among those from marginally above average areas. There were 143 readmissions, with highest 30.07% from marginally above average areas and lowest 0.70% from extremely disadvantaged areas. Conclusion Notable sociodemographic disparities were identified in frailty outcomes and healthcare utilization. These findings provide a clinically grounded, region-specific view of the relationship between frailty and deprivation. Furthermore, suggested that intermediate socioeconomic status, rather than severe deprivation, may correlate with poorer health outcomes among older adults. This underscores the necessity for targeted interventions and equitable resource allocations within this population.