Frailty in older Mexican-American and European-American adults: is there an ethnic disparity?

Because conventional frailty screening criteria have been standardized in predominantly European-American (EA) cohorts, applying them to ethnically diverse populations may result in inaccurate estimation of frailty prevalence in ethnic minorities. The objective of this study was to determine whether use of ethnic-specific criteria (EC) to characterize frailty in a bi-ethnic cohort results in significant differences in frailty prevalence when compared with the prevalence obtained using conventional criteria (CC). Data were from a random sample of community-dwelling Mexican Americans (MAs) (n=394) and EAs (n=355) aged 65 to 80 who participated in the baseline examination of the San Antonio Longitudinal Study of Aging. Frailty was defined as three or more of five characteristics: slow walking speed, weak grip strength, low energy expenditure, self-reported exhaustion, and weight loss. For CC, walking speed was standardized to height and sex, grip strength was standardized to body mass index and sex, and energy expenditure was standardized to sex using the pooled sample. For EC, these criteria were applied within each ethnic group. Frailty prevalence in MAs and EAs was compared using chi-square statistic. Using CC, a higher proportion of MAs than EAs were frail (11.3% vs 7.0%, P=.045). Using EC, there was no difference in frailty prevalence between MAs and EAs (9.9% in both ethnic groups). The application of conventional frailty screening criteria in a bi-ethnic cohort results in a higher prevalence of frailty in MAs than in EAs. In determining whether there are ethnic disparities in frailty, future studies should carefully consider whether CC or EC should be applied.