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"Socioeconomic Status is associated with Frailty: the Women's Health and Aging Studies"
  1. Sarah L Szanton1,
  2. Christopher L Seplaki2,
  3. Roland J Thorpe III3,
  4. Jerilyn K Allen4,
  5. Linda P Fried5
  1. 1 Johns Hopkins University Center on Aging and Health, United States;
  2. 2 Johns Hopkins University Bloomberg School of Public Health, Center on Aging and Health, United States;
  3. 3 Johns Hopkins University Bloomberg School of Public Health, Hopkins Center for Health Disparities So, United States;
  4. 4 Johns Hopkins University Bloomberg School of Public Health, United States;
  5. 5 Columbia University Mailman School of Public Health, United States
  1. * Corresponding author; email: sszanton{at}


Background: Frailty is a common risk factor for morbidity and mortality in older adults. Although both low socioeconomic status (SES) and frailty are important sources of vulnerability, there is limited research examining their relationship. We sought to determine 1) the extent to which low SES was associated with increased odds of frailty and 2) whether race was associated with frailty, independent of SES.

Methods: We conducted a cross-sectional analysis of the Women’s Health and Aging Studies using multivariable ordinal logistic regression modeling to estimate the relationship between SES measures with frailty status in 727 older women. Control variables included race, age, smoking status, insurance status, and co-morbidities.

Results: Ten per cent of the sample were frail, 46% were intermediately frail, and 44% were robust. In adjusted models, older women with less than a high school degree had a threefold greater odds of frailty compared to their more educated counterparts. Those with less than $10,000 yearly income had two times greater odds of frailty than their wealthier counterparts. These findings are independent of age, race, health insurance status, co morbidity, and smoking status. African Americans were more likely to be frail than Caucasians (p<0.01). However, after adjusting for education, race was not associated with frailty. The effect of race was confounded by socioeconomic position.

Conclusions: In this population-based sample, odds of frailty were increased for those of low education or income regardless of race. The growing population of older adults with low levels of education and income render these findings important.

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