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Social Position and Frailty

Published online by Cambridge University Press:  20 August 2013

Philip D. St. John ,
Patrick R. Montgomery  and
Suzanne L. Tyas
Philip D. St. John*
Affiliation:
Section of Geriatric Medicine, Department of Medicine, and the Centre on Aging, University of Manitoba
Patrick R. Montgomery
Affiliation:
Vancouver Island Health Authority
Suzanne L. Tyas
Affiliation:
School of Public Health and Health Systems, and Department of Psychology, University of Waterloo
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Philip St. John, M.D., M.P.H., F.R.C.P.C. GE 547 Health Sciences Centre 820 Sherbrook Street University of Manitoba Winnipeg, MB R3A 1R9 ([email protected])
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Abstract

This study sought to determine (1) if measures of social position are associated with frailty; (2) if any observed association between social position and frailty is a threshold or gradient effect; and (3) if any observed association is independent of possible confounders. Data were drawn from a sample of 1,751 community-dwelling adults, aged 65 and older, living in the Canadian province of Manitoba in 1991. Education, self-reported income adequacy, and self-reported income satisfaction were used as measures of social position. Frailty was graded based on functional loss, cognition, and urinary incontinence. Multivariate regression analyses revealed, after adjusting for possible confounding factors, that all measures of social position were strongly associated with frailty in a gradient, rather than a threshold, manner. We conclude that social gradients for frailty are present in older adults, although a causal mechanism is not yet clear.

Résumé

Cette étude visait à déterminer (1) si des mesures de position sociale sont associées à la fragilité, (2) si une association observée entre la position sociale et la fragilité est un effet de seuil ou de gradient, et (3) si une relation observée est indépendante des facteurs de confusion possibles. Les données ont été tirées d’un échantillon de 1 751 adultes, habitants des communautés, âgés de 65 ans et plus, habitant la province canadienne de Manitoba en 1991. On a utilisé, comme mesures de la position sociale l’éducation, et la suffisance et la satisfaction du revenu selon auto-évaluation personnelle. La précarité a été classée selon la perte fontionnelle, la cognition et l’incontinence urinaire. Des analyses de régressions multiples ont révelés, après ajustement pour les facteurs possibles de confusion, que toutes les mesures de la position sociale étaient fortement associées à la fragilité par gradient d’effet, plutôt que d’effet de seuil. Nous concluons que les gradients sociaux de la fragilité sont présents chez les adultes âgés, même si un mécanisme causatif n’est pas encore clair.

Keywords

agingaccumulation of deficitsfrailtysocial positionsocioeconomic statusvieillissmentdéficits accumulésfragilité (précarité)position socialestatut socio-économique
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 32 , Issue 3 , September 2013 , pp. 250 - 259
Copyright
Copyright © Canadian Association on Gerontology 2013 

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