Which population groups are at risk and why?
This section will focus on core epidemiological issues that take account of fixed risk factors (such as age, gender, ethnicity, family history) and modifiable risk factors (such as behaviour). The wider determinants of health (such as housing, transport and environment) are also considered.
Age
Adults aged 85 and over are at highest risk of frailty in the UK. The National Institute for Health and Care Research evidence review reports that just over half of people over 85 live with moderate or severe frailty4 . Frailty transition rates also increase steeply with age5
Gender
Women are at higher risk of frailty than men, a major longitudinal analysis of English primary care data (2006-2017) found frailty transitions were independently associated with female sex, meaning women were more likely than men to progress from being fit to any level of frailty5, 6.
Socioeconomic status
People living in areas of higher socioeconomic deprivation are at the greatest risk of frailty. A 2024 national evidence review found that deprivation increases the risk of frailty, with people in the most deprived areas being twice as likely to experience frailty compared to those in the least deprived6 , evidence of which is seen in further studies4.
Qualifications
People with lower educational attainment are at higher risk of frailty, with educational level playing a mediating role in frailty risk. Specifically, lower educational attainment has been linked to a higher frailty index whereby this group were more likely to accumulate health deficits associated with frailty7.
Mental health
People with severe mental illness (SMI) are at highest risk of frailty, a UK Biobank study found that individuals with SMI had a 3-18 times higher prevalence of frailty compared to those without8. Although lower than with those with SMI, frailty is more common in people with common mental disorders9.
Ethnicity
A review summarising UK frailty research found that Asian ethnicity increases the risk of living with frailty, independent of age, gender and deprivation10.