Later life precarity and longitudinal frailty trajectories in older adults

Abstract The concept of precarity is increasingly being applied in social gerontology to understand risks and uncertainties faced by older adults. However, existing research has not captured precarity quantitatively nor has it modelled its effect on older adults’ health. We therefore develop a Later Life Precarity Index and model its association with frailty. Using longitudinal data on 15,733 older adults from the English Longitudinal Study of Ageing, we examine the association between frailty and risks across the domains of finances, pensions, employment, housing, relationship and unpaid care-giving. We then develop the Later Life Precarity Index and model its longitudinal association with a Frailty Index using hybrid panel regression. The results indicate that multiple social risks are strongly and independently associated with frailty, particularly around finances, housing, fuel poverty and food insecurity. In longitudinal models, the precarity index explains both between-individual differences and within-individual changes in frailty and performs substantially better than standard measures of socio-economic status (wealth and education). The strong longitudinal association of the precarity index with frailty suggests that social gerontology’s growing focus on precarity is a useful lens for understanding the diverse, changing and new forms of social risk that impact frailty. By developing, testing and sharing this novel measure of later life precarity, this study brings potential for new understandings of the evolving drivers of inequalities in the health of older adults.