Frailty Unveiled: How Sexual and Gender Minorities Face Unique Aging Challenges
Ever heard of frailty? It's a medical term that describes a state where your body is more vulnerable to stressors like illness or injury, and it's a key indicator of how well you're aging. Now, imagine being a sexual or gender minority (like LGBTQ+ individuals) and facing a higher risk of frailty. Groundbreaking research has developed a new tool called the AoU-FI (All of Us Frailty Index) to measure frailty in adults over 50. This tool revealed that sexual and gender minority adults are more likely to be frail compared to their heterosexual counterparts.
The AoU-FI is a scoring system that uses 33 different health indicators to assess frailty. The study found that 26% of sexual and gender minority adults were frail, compared to 19% of non-minority adults. What's even more alarming is that frailty in these minorities is linked to a higher risk of mortality. This calls for immediate attention to understand how frailty uniquely impacts this community and what can be done to mitigate it.
Article Information
Frailty Among Sexual and Gender Minority Older Adults: The All of Us Database
Published in J Gerontol A Biol Sci Med Sci, Chelsea N Wong et al.
Abstract
Background: Despite known disparities in health status among older sexual and gender minority adults (OSGM), the prevalence of frailty is unknown. The aim of this study was to develop and validate a deficit-accumulation frailty index (AoU-FI) for the All of Us database to describe and compare frailty between OSGM and non-OSGM participants.
Methods: Developed using a standardized approach, the AoU-FI consists of 33 deficits from baseline survey responses of adults aged 50+. OSGM were self-reported as "not straight" or as having discordant gender and sex assigned at birth. Descriptive statistics characterized the AoU-FI. Regression was used to assess the association between frailty, age, and gender. Validation of the AoU-FI used Cox proportional hazard models to test the association between frailty categories (robust <0.15, 0.15 ≤ pre-frail ≤ 0.25, frail >0.25) and mortality.
Results: There were 9 110 OSGM and 67 420 non-OSGM with sufficient data to calculate AoU-FI; 41% OSGM versus 50% non-OSGM were robust, whereas 34% versus 32% were pre-frail, and 26% versus 19% were frail. Mean AoU-FI was 0.19 (95% confidence interval [CI]: 0.187, 0.191) for OSGM and 0.168 (95% CI: 0.167, 0.169) for non-OSGM. Compared to robust, odds of mortality were higher among frail OSGM (odds ratio [OR] 6.40; 95% CI: 1.84, 22.23) and non-OSGM (OR 3.96; 95% CI: 2.96, 5.29).
Conclusions: The AoU-FI identified a higher burden of frailty, increased risk of mortality, and an attenuated impact of age on frailty among OSGM compared to non-OSGM. Future work is needed to understand how frailty affects the OSGM population.
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