Social position and frailty.

This study sought to determine (1) if measures of social position are associated with frailty; (2) if any observed association between social position and frailty is a threshold or gradient effect; and (3) if any observed association is independent of possible confounders. Data were drawn from a sample of 1,751 community-dwelling adults, aged 65 and older, living in the Canadian province of Manitoba in 1991. Education, self-reported income adequacy, and self-reported income satisfaction were used as measures of social position. Frailty was graded based on functional loss, cognition, and urinary incontinence. Multivariate regression analyses revealed, after adjusting for possible confounding factors, that all measures of social position were strongly associated with frailty in a gradient, rather than a threshold, manner. We conclude that social gradients for frailty are present in older adults, although a causal mechanism is not yet clear.