Prevalence and incidence of frailty in Aboriginal Australians, and associations with mortality and disability

This study aimed to determine the prevalence and incidence of frailty, and associations with mortality and disability, in remote-living Aboriginal people. Frailty represents a loss of homeostasis, markedly increasing the risk of death and disability. Frailty has been measured in several ethnic groups, but not, to the authors’ knowledge, in Aboriginal Australians.

Between 2004 and 2006, the authors recruited 363 Aboriginal people aged ≥45 years from 6 remote communities and one town in the Kimberley region of Western Australia (wave 1). Between 2011 and 2013, 182 surviving participants were followed-up (wave 2). The authors assessed frailty with an index, comprising 20 health-related items.

At wave 1 (W1), 188 participants (65.3%) were frail, and of robust people at W1 who participated in wave 2, 38 (51.4%) had become frail. Frailty emerged at a younger age than expected. A total of 109 people died, of whom 80 (73.4%) were frail at W1. Frailty at W1 was not associated with becoming disabled, but was associated with mortality.

Frailty in remote-living Aboriginal Australians is highly prevalent; substantially higher than in other populations. Research to understand the underlying causes of frailty in this population, and if possible, reverse frailty, is urgently needed.