Frailty in Low- and Middle-Income Countries

Frailty is a geriatric syndrome, and its prevalence varies in different studies according to socioeconomic status, sex, multimorbidity, level of education, occupation, and income. Older adults who live in poverty display higher levels of frailty. High-income countries (HICs) show lower incidences of frailty and prefrailty compared with low- to middle-income countries (LMICs). In LMICs, the odds of having frailty were 37% lower, and for prefrailty 70% lower than in HICs. The most used instrument to measure frailty was the Fried’s phenotype criteria. The second most widely used tool was the Edmonton Frailty Scale. Frailty assessment in LMICs sometimes is difficult due to the lack of population-based studies, limited resources including equipment and trained personnel, and the use of tools that have not been validated for different populations of these countries. Multicomponent interventions are recommended but must be adapted to local, low resource environments. These interventions consist of exercise, medication deprescribing, depression treatment, nutritional supplementation, and home risk reduction.