Regional variation in the prevalence of frailty among very old adults in Germany: Findings of the nationwide study “Old Age in Germany” (D80+)

BACKGROUND: Frailty is a key geriatric syndrome that determines the care of the affected old adults. The goal of this study is to quantify the prevalence and regional distribution of frailty among very old adults in Germany, on which no nationwide data have been available to date. METHODS: We analyzed data obtained by questionnaire from 9855 persons aged 80 and above in the nationwide D80+ survey. Frailty was operationalized with a frailty index (cutoff value: ≥0.25) encompassing 40 items. Its prevalence was estimated with logistic regression adjusted for age and sex. Socio-economic factors (education, income, type of residence) were additionally taken into account in an extended model. RESULTS: The overall prevalence of frailty was 54.5% (95% confidence interval [53.2; 55,7]). Frail persons were more commonly female, widowed, living in a nursing or old-age home, and of lower socio-economic status. Regional variation was identified that persisted after the additional consideration of socio-economic factors and type of residence. The two federal states with the lowest prevalence were Bremen (42.6%) and Schleswig-Holstein (49.9%); those with the highest prevalence were Brandenburg (59.7%) and Saxony (60.8%). CONCLUSION: Frailty is highly prevalent among very old adults in general, with regional disparities that imply an effect of region-specific factors. The awareness of regional variability and a better understanding of its causes can be used to inform future public health strategies and regional care planning.