University of Manchester

Dunhill Medical Trust

DL_2024_010

Frailty is a clinical condition that makes an older person more vulnerable to worsening health, increasing disability, and even death. In recent times, the COVID-19 pandemic may have led to more people becoming frail in the UK. Mandated lockdowns during the pandemic led to older adults doing less physical activity and experiencing poor mental health, and these are known to worsen frailty. To date, there is no research on how frailty levels have changed in the population before, during, and after the pandemic. In this study, we will examine frailty changes during the pre-pandemic and pandemic periods (2015–present) in Scotland. We plan to use primary care and hospital data of older adults aged 50 and over living in Scotland. Our findings would help identify older adults who developed frailty during the pandemic, and whose frailty levels worsened. We can also identify factors that contributed to worsening frailty, helping clinicians design targeted plans for patients.

Frailty is an age-related clinical condition associated with greater health and social care needs, resulting in higher national-level healthcare use and expenditure. Mandated social distancing measures during the pandemic may have led to older adults being less physically active and experiencing poor mental health, which are known risk factors for frailty. Thus, it can be hypothesised that the mandated COVID-19–related restrictions contributed to worsening frailty levels and greater frailty incidence in the UK. To date, there are no large-scale studies examining population-level frailty changes during and after the pandemic. In Scotland, approximately 35% of the population aged >65 years were mildly frail, 15% were moderately frail, and 5% severely frail in 2019 (Health Improvement Scotland 2019). Thus, the findings of this study would help determine whether more older adults became frail during the pandemic. Using statistical modelling methods, we can also identify sub-populations with varying frailty progression patterns, i.e. “frailty phenotypes”, across the pre-pandemic, pandemic, and post-pandemic periods. These frailty phenotypes would help understand population-level frailty changes by factors such as deprivation levels in Scotland. This study would highlight whether frailty levels worsened since the pandemic began, and whether these frailty trends reversed or sustained well beyond the peak of the pandemic. Clinicians would also benefit from understanding the trends in frailty changes and the contributing factors, helping design targeted frailty management plans for patients in their GP practices.

Public Health Research

18/06/2024

De-Personalised

TRE