Frailty knowledge level and its influencing factors among older adults in China

Population aging is a prevalent public health problem faced by many countries. The global population aged 65 and older is expected to rise from ten percent in 2022 to sixteen percent by 2050.1 With the population aging, the incidence of age-rlated chronic diseases has increased significantly, putting older people at an increased risk of disability, loss of independence, and premature death.2

Frailty is a geriatric syndrome characterized by a cumulative decline in a person's functions across multiple physiological systems and increased susceptibility to stressors.3 As a result, various health indicators of older adults are negatively affected, resulting in the deterioration of their physical health, mental health, and social engagement.4,5 The prevalence of frailty among older adults in China ranges from 5.9% to 17.4%, and the prevalence of pre-frailty ranges from 26.8% to 62.8%.6 Since frailty is a dynamic process and can be viewed as a modifiable state, early identification and intervention are essential to prevent or reverse frailty and its negative consequences.7, 8, 9

The implementation of frailty prevention and intervention requires close collaboration among physicians, rehabilitation therapists, and nurses.10 In addition, it is crucial to raise frailty knowledge in older adults, which allows them to actively participate in the prevention and treatment of frailty.11 Previous studies have shown that older adults lack knowledge and even have misunderstandings about frailty, believing that all older adults suffer from frailty and that treatment is futile.12, 13, 14, 15 Negative perceptions of frailty may adversely affect older adults’ health behaviors, leading to avoidance and missed opportunities for early detection and appropriate interventions for frailty.16, 17, 18, 19 This may result in loss of independence and compromised quality of life in this population. Therefore, to engage in preventative strategies, older adults must first possess knowledge of frailty.

Recently, a study explored factors associated with older adults’ awareness of frailty in Japan. Factors such as age, sex, education, income, exercise, Dietary Variety Score (DVS), social activity, social isolation, and frailty, were found to affect frailty awareness.11 Nevertheless, to our knowledge, no study has investigated how much older adults in China know about frailty and factors influence their frailty knowledge level. Since the prevalence of frailty and its associated costs are expected to increase as population aging continues to escalate in China, relevant studies are needed. This study sought to examine frailty knowledge level and its influencing factors in community-dwelling older adults in China. We hypothesized that sociodemographics, lifestyle, and health were associated with frailty knowledge level in older adults in China. The findings of this study will inform policy and interventions to reduce frailty and its associated outcomes and improve quality of life in the growing number of older adults in China.

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