On the Relationship Between Frailty, Nutritional Status, Depression and Quality of Life Among Older People

Frailty is a multidimensional geriatric syndrome associated with physical, psychological and social changes. There is a paucity of research on frailty in Sub-Saharan African (SSA) countries, especially Ethiopia.

To assess the initial correlations among frailty, nutritional status, depression and QOL (quality of life) in a group of older people in Ethiopia who are later enrolled in a study examining the effects of a nurse-led community intervention on frailty and related health outcomes.

Data from 68 community-dwelling individuals 60 years of age, or over, were collected. Frailty was measured using the Amharic version of the Tilburg Frailty Indicator. The statistical analysis included Spearman's rank correlation coefficient for degrees of association, Mann-Whitney U-test for variables with two categories and Kruskal-Wallis for variables with three or more categories.

The mean frailty score for participants was 7.3 (±1.9). Participants with higher frailty scores had lower nutritional status (r_s = -0.46, p < 0.01). There was a statistically significant relationship (positive) between frailty scores and depression (r_s = 0.39, p < 0.01). Depressed (Md = 9, n = 23) and non-depressed frail older people (Md = 7, n = 45) showed a significant difference in their overall frailty score, U = 330.50, z = -2.49, p = 0.01, r = 0.30. There was an inverse significant association between the level of frailty across different domains in the QOL: physical (r_s = -0.44, p < 0.01), psychological (r_s = -0.45, p < 0.01), social relations (r_s = -0.29, p < 0.05) and environmental (r_s = -0.47, p < 0.01).

The findings from this study were consistent with those from across middle-income and high-income countries.

This research indicates that older people living in communities who are identified as frail often suffer from a poor nutritional status, depression and reduced QOL. It suggests that healthcare professionals in Sub-Saharan countries would benefit from recognising the frailty in this population, and developing interventions aimed at enhancing nutrition, mental health and overall well-being.