The Impact of Income- and Asset-Poverty on Frailty Worsening Among Older Adults in 10 European Countries: A Longitudinal Analysis Using Share (2004-2013)

Recent studies documented effects of education and income on frailty status in old age, albeit mostly using cross-sectional data. Few studies have concentrated on the dynamics of frailty worsening across time or have focused on the role of material deprivation in income- and asset-poor households. Furthermore, potential cross-national differences and contextual effects regarding old age frailty have not been assessed so far. The objective of this study was therefore to assess the impact of both income- and asset poverty on the dynamics in the frailty index (FI) conceived as a systemic indicator of biological ageing in community-dwelling older adults (65+) in Europe. We used panel data consisting of 21,571 observations in 6.902 older adults across 10 years (2004-2013) and 10 European countries from the Survey of Health, Ageing and Retirement in Europe (SHARE). Results from growth curve models showed significantly higher average levels of frailty in early old age and a higher rate of subsequent frailty worsening over time among asset-poor older adults compared to their non-poor counterparts. Furthermore, we found average frailty in early old age and frailty worsening to be higher in the Mediterranean and lower in Northern European countries. Finally, the impact of asset-poverty on both initial frailty level and frailty worsening was strongest in the Mediterranean countries and lowest in Switzerland.