Prevalence and predictors of frailty among community-dwelling older adults with hypertension in China

Chen, Bai; Jiang, Yan; Sharoni, Siti Khuzaimah Ahmad; Fauzi, Rosuzeita; Isa, Siti Nor Ismalina

doi:10.1590/1806-9282.20250997

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Original Article • Rev. Assoc. Med. Bras. 71 (11) • 2025 • https://doi.org/10.1590/1806-9282.20250997 linkcopy

Prevalence and predictors of frailty among community-dwelling older adults with hypertension in China

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE: The aim of the study was to determine the prevalence, socio-demographic, and health-related predictors of frailty among community-dwelling elderly Chinese with hypertension.

METHODS: It's a cross-sectional survey design among 338 respondents; the Chinese version of the Tilburg Frailty Assessment Scale was used to screen elderly hypertensive adults for frailty. The socio-demographic data were collected using a self-developed questionnaire. Data collected were analyzed using binary logistic regressions at a of 95%CI.

RESULTS: The result of the study shows that the prevalence of frailty among community-dwelling older adults with hypertension in Henan province was 32.5%. The result of the socio-demographic predictors was being a female (p=0.001, OR 3.669 [CI 1.967–6.843]) and living in a rural area (p=0.032, OR 3.487 [CI 1.116–10.898]). While the leading health predictors were found to be a comorbidity of three or more conditions (p=0.001, OR 57.233 [CI 21.883–149.689]); history of hypertension spanning longer than 11 years (p=0.001, OR 10.541 [CI 5.404–20.561]).

CONCLUSION: More attention should be focused on elderly hypertensive women to reduce the impact.

KEYWORDS:
Frailty; Aged; Frail elderly; Hypertension; China

Variable		Frequency (n)	Percentage (%)
Age (years), M±SD	65.99±4.98
Gender	Male	162	50.6
Gender	Female	158	49.4
MHI Status (RMB), M±SD	6,768.56±2755.64 (942.671 USD)*
Marital status	Married	190	59.6
	Widow	56	17.6
	Divorced	25	7.8
	Cohabitation	49	15.3
Place of residence	City	300	93.8
Place of residence	Countryside	20	6.2
Smoking status	Yes, every day	8	2.5
	Yes, not daily	91	28.4
	Have quit	60	18.8
	Never	161	50.3
Alcohol	Yes, occasionally	97	30.3
	Have quit	68	21.3
	Never	155	48.4
Exercise	Never	48	15.0
	Occasionally	133	41.6
	Less than three times/week	101	31.6
	More than three times/week	38	11.9
Comorbidity (aside from hypertension)	1	110	34.4
	2	149	46.6
	3 and above	61	19.1
History of blood pressure (years)	1–5	140	43.8
	6–10	103	32.2
	≥11	77	24.0
Low-salt diet	Yes	34	10.6
Low-salt diet	No	286	89.4
Sleep status	Not good	42	13.1
	Normal	257	80.3
	Very good	21	6.6
History of surgery	Yes	92	28.8
History of surgery	No	228	71.2
Polypharmacy	Yes	146	45.6
Polypharmacy	No	174	54.4
BMI, M±SD	Underweight	6	1.9
	Normal weight	227	70.9
	Overweight	84	26.3
	Obesity	3	0.9
Level of BP	Mild	154	48.1
Level of BP	Moderate	115	36.0
	Severe	51	15.9
Frail status	Non-frail	216	67.5
Frail status	Frail	104	32.5

Predictors		B	OR	95%CI		Sig
Predictors		B	OR	Lower	Upper	Sig
Age (years)		0.287	1.333	1.232	1.442	0.001
Age category	60–65	0	1
	66–70	4.124	0.016	0.004	0.074	0.001
	71–80	-2.127	0.119	0.026	0.546	0.006
	>80	-1.961	0.141	0.028	0.704	0.017
Gender	Male	0	1
Gender	Female	1.300	3.669	1.967	6.843	0.001
Marital status	Married	0	1
	Widow	-0.700	0.497	0.262	0.942	0.032
	Divorced	-0.313	0.731	0.337	1.589	0.43
	Cohabitation	-3.055	0.047	0.006	0.376	0.004
Place of residence	City	0	1
Place of residence	Countryside	1.249	3.487	1.116	10.898	0.032

Predictors		B	OR	95%CI		Sig.
Predictors		B	OR	Lower	Upper	Sig.
Systolic BP		-0.020	0.98	0.941	1.021	0.330
Diastolic BP		0.085	1.088	1.01	1.172	0.025
Level of BP	Mild	0	1
	Moderate	1.6	4.952	2.768	8.862	0.001
	Severe	2.148	8.571	4.183	17.564	0.001
Smoking	Yes, every day	0	1
	Yes, not daily	1.634	5.124	0.001	43,847.536	0.724
	Have quit	-1.508	0.221	0.032	1.535	0.127
	Never	-2.251	0.105	0.016	0.673	0.017
Exercise	Never	0	1
	Occasionally	0.782	2.186	1.075	4.443	0.031
	Less than three times	-0.940	0.391	0.169	0.905	0.028
	More than three times/week	0.233	1.263	0.506	3.152	0.617
Alcohol	Yes, occasionally	0	1
	Have quit	0.673	1.961	0.949	4.052	0.069
	Never	1.154	3.17	1.734	5.794	0.001
Sleep status	Not good	0	1
	Normal	-2.632	0.072	0.031	0.170	0.001
	Good	-4.605	0.010	0.001	0.087	0.001
Comorbidity	1	0	1
	2	1.548	4.703	2.183	10.129	0.001
	3 and above	4.047	57.233	21.883	149.689	0.001
History of hypertension	1–5	0	1
	6–10	1.273	3.570	1.903	6.698	0.001
	>11	2.355	10.541	5.404	20.561	0.001
Polypharmacy	Yes	0	1
Polypharmacy	No	-2.519	0.081	0.045	0.145	0.001
History of surgery	Yes	0	1
History of surgery	No	-1.551	0.212	0.126	0.356	0.001
Low salt diet	Yes	0	1
Low salt diet	No	2.183	8.87	2.083	37.770	0.003

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1USD=0.13927 RMD as at 10/11/2024; BMI: body mass index; BP: blood pressure; SD: standard deviation.