Association of Frailty with Functional Difficulty in Older Ghanaians: Stability Between Women and Men in Two Samples with Different Income Levels

Abstract

Research to date suggests that frailty is higher in women and is associated with functional difficulty. This study builds on the evidence by examining the association between frailty and functional difficulty between lowand higher-income groups and between older men and women in these income groups. Methods This study adopted a cross-sectional design that complied with the STROBE checklist and included steps against confounding and common methods bias. The population was community-dwelling older adults aged 50 years or older in two urban neighbourhoods in Accra, Ghana. Participants were either in the low-income group in a low socioeconomic neighbourhood (n=704) or the higher-income group in a high socioeconomic neighbour‑hood (n=510). The minimum sample necessary was calculated, and the hierarchical linear regression analysis was utilised to analyse the data. Results Frailty was positively associated with functional difficulty in the low- and higher-income samples, but this association was stronger in the higher-income sample. Frailty was positively associated with frailty in men and women within the low- and higher-income samples. Conclusion The association of frailty with functional difficulty was consistent between low- and higher-income samples, although the strength of the relationship differed between these samples. In both income samples, the fore‑going relationship was consistent between men and women, although the strength of the relationship differed between men and women.