सार
Objectives: Variability in the prevalence of frailty in older populations suggests a need for contextspecific information about the phenotype. We characterized a frailty phenotype variant in community
dwelling Yoruba Nigerians who were aged 60 years or over.
Methods: Cross-sectional analysis of the first of three follow-up waves in a five year prospective study of
a household multistage sample of 1595 stroke- and dementia-free persons. We characterized frailty by
relying on locally validated tools and the Cardiovascular Health Study (CHS) principle of ‘vicious cycle
of decline’. The association of frailty with disability, quality of life (QoL) and healthcare utilization was
investigated using multivariate logistic regression analyses.
Results: We found a prevalence of 7.3% (95% C. I=5.9-9.0) for the full frail phenotype and 62.1% (95%
C. I=59.9-64.3) for the prefrail phenotype. In fully adjusted logistic regression models, frail respondents
had approximately two, five and eight times the odds of greater healthcare utilization (O. R=1.8, 95% C.
I=1.2-2.7), disability (O. R=5.4, 95% C. I=3.2-9.2) and poor QoL (O. R=8.4, 95% C. I=4.8-14.6)
respectively.
Conclusion: The prevalence of frailty in this population is similar to those reported in other surveys. The
results suggest that with cohort specific modifications, the risk profile of frailty as originally
conceptualised in North Americans is applicable to, and has suggestive evidence of validity in, this subSaharan African population.
Keywords: Frailty syndrome; low income population; frailty index
Résumé
Objectifs : La variabilité dans la prévalence de fragilité chez les populations âgées suggère un besoin
d’information contextuelle-spécifique sur le phénotype. Nous avons caractérisé une variante du phénotype
de fragilité chez des Yorouba Nigérians vivant en communauté qui étaient âgés de 60 ans ou plus.
Méthodes : Analyse transversale de la première des trois vagues de suivi d’une étude prospective de cinq
ans sur un échantillon aléatoire à plusieurs degrés de ménages constitué de 1595 personnes sans AVC ni
démence. Nous avons caractérisé la fragilité en nous basant sur des outils validés localement et sur le
principe du ‘cycle vicieux de déclin’ de l’Étude sur la santé cardiovasculaire (ESC). L’association de
la fragilité avec un handicap, la qualité de vie (QV) et l’utilisation des soins de santé a été étudiée
en utilisant des analyses de régression logistique multivariée.
Résultats : Nous avons trouvé une prévalence de 7,3% (95% IC = 5,9 à 9,0) pour le phénotype complet
fragile et de 62,1% (95% IC = 59,9 à 64,3) pour le phénotype prefragile. Dans les modèles de régression
logistique entièrement ajustés, les répondants fragiles présentaient avec environ deux, cinq et huit fois
plus de chances d’avoir une plus grande utilisation des soins de santé (OR = 1,8, 95% IC = 1,2-2,7), un
handicap (OR = 5,4, 95 % IC = 3,2 à 9,2) et mauvaise qualité de vie (OR = 8,4, 95% IC= 4,8 à 14,6)
respectivement.
Conclusion : La prévalence de fragilité dans cette population est similaire à celle rapportée dans d’autres
enquêtes. Les résultats suggèrent qu’avec des modifications à cohorte-spécifiques, le profil de risque de
fragilité tel que conçu initialement chez les Américains du Nord est applicable à, et offre des preuves
évocatrices de validité dans, cette population d’Afrique subsaharienne.
Mots-clés : syndrome de fragilité ; population à faible revenu ; index de fragilité
Correspondence: Dr. A. Ojagbemi, Department of Psychiatry, College of Medicine, University of
Ibadan, Ibadan, Nigeria. E-mail: drakinjagbemi@yahoo.com
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