Correlates of Frailty among Older Persons in Rural Eastern Uganda: A Cross-sectional Survey

ABSTRACT

Introduction: Although frailty has been extensively studied and in high-income settings, its determinants in SSA remain poorly understood, and contextual factors may differ substantially. The study aimed to assess the prevalence and correlates of frailty among older persons in two rural districts of Eastern Uganda: Busia and Namayingo.

Methods: We used cross-sectional data from two districts of Busia and Namayingo in rural eastern Uganda among 598 older persons aged 60 years and above. Differences in characteristics by frailty status were tested using chi-square tests for categorical variables and t-tests or non-parametric equivalents for continuous variables. Using a stepwise approach, we used multivariable logistic regression analyses to examine the factors associated with frailty.

Results: The overall prevalence of frailty and pre-fail was 34.3% and 52.7% respectively.  A unit decrease in average handgrip strength was associated with increased odds of frailty (OR=0.96; CI=0.93-0.98) while a unit increase in loneliness was associated with increased odds of frailty (OR=1.08; CI=1.04-1.12). Older persons who were living alone were more likely to be frail (OR=1.62; CI=1.16-2.26) than their counterparts who were not living alone. Frailty was more likely to be reported among depressed (OR=2.11; CI=1.45-3.07) or hypertensive (OR=1.49; CI=1.05-2.11) older persons than their counterparts.

Conclusions: Frailty is highly prevalent among older persons in rural Eastern Uganda and is shaped by a combination of physical, psychological, and social factors. The findings support the integration of frailty screening into primary healthcare and community-based programming, with attention to the psychosocial context of older adults.

Keywords: Frailty; Aged; Rural; Uganda; sub-Saharan Africa