Mapping Social and Physical Frailty in the Peruvian Amazon: Associated Factors Among Older Adults

Background/Objectives: To analyze the determinants of frailty among older adults residing in the Peruvian Amazon, focusing on four complementary frailty-related outcomes. Methods: A cross-sectional study was conducted using secondary data from the Amazon frail study. Four multivariable Poisson regression models were specified. Associations were estimated using prevalence ratios (PRs) with their corresponding 95% confidence intervals (95% CIs), employing robust variance estimation to account for potential heteroskedasticity. Results: The sample included 429 older adults (≥60 years), predominantly female (64.0%), with most participants aged 60-79 years (85.8%). The prevalence of the main variables of interest was: dynapenia (51.5%), low physical performance (32.2%), social frailty (66.4%), and frailty according to the Fried phenotype (26.3%). In adjusted models, altered muscle mass showed the strongest association with dynapenia (PR = 2.08, 95%CI = 1.74-2.50). Likewise, functional dependence and social frailty were significantly associated with low physical performance (PR = 1.65 and PR = 1.57, respectively). A higher potential support relationship (upper tertile) was associated with a lower prevalence of social frailty (PR = 0.56, 95%CI = 0.41-0.88), whereas low physical performance was strongly associated with frailty defined by the Fried phenotype (PR = 3.71, 95%CI = 2.60-5.34). Conclusions: Frailty among older adults in the Peruvian Amazon is highly prevalent and characterized by a distinctly multidimensional nature. It is associated with muscular, functional, cognitive, and social factors that may reflect interrelated vulnerabilities at both the individual and community levels.