Prevalence of frailty among older South Asians living in the UK

Abstract

Frailty is a geriatric syndrome that is common among older people and is commonly assessed by two tools: Frailty Phenotype (FP) and Frailty Index (FI). The health determinants such as age, sex, lifestyle and socioeconomic status (SES) along with the incidence of certain illnesses vary with a person’s ethnicity. With the continuous increase in the older SA population living in the UK, the study to find the difference in the prevalence of frailty between SAs and Whites is important. This will help to take the right intervention on time to prevent further frailty-related deterioration, and to maintain the quality of life in later life. This also helps to ensure the national services thus designed are reachable and beneficial to the migrant SA population.

This PhD aims to determine whether SAs aged over 65 years living in the UK differ from White British people of the same age in the development and life course of frailty.

This PhD study has three objectives with a separate quantitative research approach. A systematic review was conducted to find the prevalence of frailty among overall SAs despite their geographical location. The study showed a high level of frailty among SAs including among females. Moreover, this study found there were no previous research studies about frailty among SA living in the UK. To fill this research gap and meet the PhD study aim, a cross-sectional prevalence study was conducted using eFI as an assessment tool. The eFI data along with IMD and IDAOPI as components for SES were extracted from GP surgeries data that are under AT Medics in East London. This study presented the prevalence of frailty as higher among ethnic minorities particularly SAs compared to Whites. The study also presented the relation of frailty to SES as the lower the SES higher the prevalence. This study consisted small population from London and could not be generalised to all SA population living in the UK.

Another retrospective longitudinal study was conducted to find out the prevalence of frailty among SAs living in England using the ELSA dataset. However, due to missing data and limited participation of SAs in the ELSA study, the population of SAs were changed to Asians allowing existing data on migrant populations to be studied. This study found the prevalence of frailty higher among Asians than Whites. Moreover, this study studied the relation of covariates: age, sex, physical activity, diet, smoking, g intake, social isolation, loneliness, and SES to the prevalence of frailty among the Asian migrant population.

This PhD study included the first-ever systematic review with a meta-analysis conducted among SAs about frailty. Moreover, this study provided a novel contribution of knowledge using secondary data sources that showed SA living in the UK have indeed higher levels of frailty incidence compared to Whites. Moreover, the study also presented the need for more studies to answer the research question. The study clearly showed the lack of representation of SAs in national-level older age research studies and shows the need for inclusion in future studies.