Frailty State Transitions and Associated Social Factors in European Older Adults

The twentieth century saw increasing life expectancy and declining fertility rates in Western countries, leading to an aging population and rising frailty—a condition marked by vulnerability due to age-related physiological decline. Frailty is dynamic and potentially reversible, making early intervention crucial. The frailty phenotype (FP) model (Fried et al., 2001) classifies individuals as non-frail, pre-frail, or frail based on weight loss, exhaustion, weakness, slow walking speed, and low physical activity. This study used data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) across 16 countries to analyze frailty transitions over eight years. The sample included 15,574 individuals aged 50 + from 2015 to 2022. Findings show frailty increased over time. Nevertheless, while frailty progression is common, some individuals improve, demonstrating frailty’s reversibility. Socioeconomic and social factors influence transitions—older age, cognitive impairment, obesity, and economic difficulties, living in a Mediterranean country, and loneliness increase frailty risk, whereas higher education, social engagement, and physical activity promote improvement. Transition probabilities indicate that once individuals become frail, they tend to remain frail, though some recover. Future research will integrate mortality data to refine transition analyses. Understanding these transitions can guide interventions to slow frailty progression and improve older adults’ well-being.