Ethnic differences in the prevalence of frailty in the United Kingdom assessed using the electronic Frailty Index

Abstract

Objective: There have been few studies in which the prevalence of frailty of different ethnic groups has been assessed in multiethnic countries. The aim of this study was to evaluate the prevalence of frailty in different ethnic groups in the United Kingdom. Methods: Anonymized electronic health records (EHR) of 13 510 people aged 65 years and over were extracted from the database of a network of general practitioners, covering 16 clinical commissioning groups in London. Frailty was determined using the electronic Frailty Index (eFI), which was automatically calculated using EHR data. The eFI was used as a categorical variable with fit and mild frailty grouped together, and moderate and severe frailty grouped as frail. Results: The overall prevalence of frailty was 18.1% (95% confidence interval [CI], 17.4%‐18.9%). The prevalence of frailty increased with age (odds ratio [OR], 1.11; 95% CI, 1.10‐1.12) and body mass index (BMI; OR, 1.05; 95% CI, 1.04‐1.06). The highest prevalence of frailty was observed for Bangladeshis, with 32.9% classified as frail (95% CI, 29.2‐36.7); and the lowest prevalence of 14.0% (95% CI, 12.6‐15.5) was observed for the Black ethnic group. Stepwise logistic regression retained ethnicity, age, and BMI as predictors of frailty. Conclusion: This pilot study identified differences in the prevalence of frailty between ethnic groups in a sample of older people living in London. Additional studies are warranted to determine the causes of such differences, including migration and socioeconomic status. It would be worthwhile carrying out a validation study of the eFI in different ethnic populations.