journal articles
LONGITUDINAL NORMS OF FRAILTY MEASURED BY THE FRAILTY INDEX: A CROSS-NATIONAL COMPARISON USING DATA FROM THE SURVEY OF HEALTH, AGING, AND RETIREMENT IN EUROPE (SHARE)
Alejandra Marroig, Fernando Massa, Ángela Gutiérrez, Adil Supiyev, Bar?? Sevi, Graciela Muniz-Terrera
BACKGROUND: Frailty, a geriatric syndrome commonly used to identify vulnerable older adults, is a public health priority. However, the lack of cross-national comparisons of frailty trajectories and their distribution constrains current understanding of normative changes in frailty for residents across different countries.
OBJECTIVE: To derive longitudinal percentiles of frailty using a consistent cross-country approach.
DESIGN: Observational study using longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE) between 2004 and 2020.
SETTING: We fit the distribution of the FI by Generalized Additive Models for Location, Scale, and Shape (GAMLSS), assessed the role of sex (male/female), education (in years), and migration status (migrant/non-migrant), and estimated the longitudinal percentiles of frailty using a consistent cross-country approach for 16 countries.
PARTICIPANTS: Individuals aged ≥65 years (N = 42,951) at study entry.
MEASUREMENTS: Frailty index (FI) based on the accumulation of deficits in 40 items.
RESULTS: The results show that education is protective against frailty in all countries (a decrease of 1.1 pp. in Switzerland to 5.7 pp. in Slovenia, all p < 0.001). In most countries, women are frailer than men and migrant individuals have higher levels of frailty than non-migrants. FI trajectories showed heterogeneity across countries. The quantiles for women and migrants suggest frailer trajectories than men and non-migrants respectively.
CONCLUSIONS: Findings from this cross-national comparison provide a framework within which the longitudinal norms of frailty trajectories from different countries can be interpreted.
CITATION:
Alejandra Marroig ; Fernando Massa ; Ángela Gutiérrez ; Adil Supiyev ; Barış Sevi ; Graciela Muniz-Terrera (2026): Longitudinal norms of frailty measured by the frailty index: A cross-national comparison using data from the survey of health, aging, and retirement in Europe (SHARE). The Journal of Frailty and Aging (JFA). https://doi.org/10.1016/j.tjfa.2026.100144