Frailty in Older American Indians: The Native Elder Care Study

Introduction: Frailty is often described as a reduction in energy reserves, especially with respect to physical ability and endurance, and it has not been examined in American Indians. The goals of this study were to estimate the prevalence of frailty and identify its correlates in a sample of American Indians. Methods: We examined data from 411 community-dwelling American Indians aged ≥55 years. Frailty was measured with weight loss, exhaustion, low energy expenditure, slowness, and weakness characteristics. Results: Slightly over 44% of participants were classified as pre-frail and 2.9% as frail. Significant correlates of a combined pre-frail and frail status identified in the fully adjusted analyses were younger age, female gender, lower levels of education, increased number of chronic medical conditions, and increased number of activities of daily living limitations. Marital status, chronic pain, and social support were not associated with pre-frail/frail status. Conclusions: Our findings point to specific areas in need of further research, including use of frailty measures that also capture psychosocial components and examining constructs of physical resilience. Targeting those with multiple chronic medical conditions may be an important area in which to intervene, with the goal of reducing risk factors and preventing frailty onset.