McKelvie Mische-Jasmine, Cruise Sharon, Ward Mark, Romero-Ortuno Roman, Kee Frank, Kenny Rose Anne, O'Reilly Dermot, O'Halloran Aisling M
Centre for Public Health, Queen's University of Belfast, Belfast, UK.
The Irish Longitudinal Study on Ageing, Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.
Eur J Public Health. 2024 Aug 1;34(4):710-716. doi: 10.1093/eurpub/ckae046.
Aimed to compare the prevalence, characteristics, and associated mortality risk of frailty in Northern Ireland (NI) and the Republic of Ireland (ROI).
Secondary analysis of the first wave of two nationally representative cohorts, the Northern Ireland Cohort for the Longitudinal Study of Ageing or NICOLA study (N = 8504) and the Irish Longitudinal Study on Ageing or TILDA study (N = 8504). Frailty was assessed using a harmonized accumulation deficits frailty index (FI) containing 30 items. FI scores classified individuals as non-frail (<0.10), pre-frail (0.10-0.24) and frail (≥0.25). Linkage to respective administrative data sources provided mortality information with a follow-up time of 8 years.
The prevalence of frailty was considerably higher in NI compared with the ROI (29.0% compared with 15.0%), though pre-frailty was slightly lower (35.8% and 37.3%, respectively). Age, female sex, and lower socio-economic status were consistently associated with a higher likelihood of both pre-frailty and frailty. In the pooled analysis, both frailty and pre-frailty were higher in NI (RR = 2.68, 95% CIs 2.45, 2.94 and RR = 1.30, 95% CIs 1.21, 1.40, respectively). Frailty was associated with an increased mortality risk in both cohorts, even after full adjustment for all other characteristics, being marginally higher in TILDA than in NICOLA (HR = 2.43, 95% CIs 2.03, 2.91 vs. HR = 2.31, 95% CIs 1.90, 2.79).
Frailty is a major public health concern for both jurisdictions. Further research and monitoring are required to elucidate why there is a higher prevalence in NI and to identify factors in early life that may be driving these differences.
旨在比较北爱尔兰（NI）和爱尔兰共和国（ROI）虚弱的患病率、特征及相关死亡风险。
对两项具有全国代表性队列的首轮数据进行二次分析，即北爱尔兰老龄化纵向研究队列（NICOLA研究，N = 8504）和爱尔兰老龄化纵向研究（TILDA研究，N = 8504）。使用包含30项指标的统一累积缺陷虚弱指数（FI）评估虚弱情况。FI评分将个体分为非虚弱（<0.10）、虚弱前期（0.10 - 0.24）和虚弱（≥0.25）。与各自的行政数据源建立关联，提供随访8年的死亡信息。
与ROI相比，NI的虚弱患病率显著更高（分别为29.0%和15.0%），尽管虚弱前期患病率略低（分别为35.8%和37.3%）。年龄、女性性别和较低的社会经济地位始终与虚弱前期和虚弱的较高可能性相关。在汇总分析中，NI的虚弱和虚弱前期患病率均更高（RR分别为2.68，95% CI为2.45，2.94和RR为1.30，95% CI为1.21，1.40）。在两个队列中，即使对所有其他特征进行全面调整后，虚弱仍与死亡风险增加相关，TILDA队列中的风险略高于NICOLA队列（HR分别为2.43，95% CI为2.03，2.91与HR为2.31，95% CI为1.90，2.79）。
虚弱是两个辖区的主要公共卫生问题。需要进一步研究和监测，以阐明NI患病率较高的原因，并确定可能导致这些差异的早年因素。
