Observational studyThe Journal of frailty & aging2026
Longitudinal norms of frailty measured by the frailty index: A cross-national comparison using data from the survey of health, aging, and retirement in Europe (SHARE).
Observational study in The Journal of frailty & aging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFrailty, a geriatric syndrome commonly used to identify vulnerable older adults, is a public health priority. However, the lack of cross-national comparisons of frailty trajectories and their distribution constrains current understanding of normative changes in frailty for residents across different countries.
objectiveTo derive longitudinal percentiles of frailty using a consistent cross-country approach.
designObservational study using longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE) between 2004 and 2020.
settingWe fit the distribution of the FI by Generalized Additive Models for Location, Scale, and Shape (GAMLSS), assessed the role of sex (male/female), education (in years), and migration status (migrant/non-migrant), and estimated the longitudinal percentiles of frailty using a consistent cross-country approach for 16 countries.
participantsIndividuals aged ≥65 years (N = 42,951) at study entry. MEASUREMENTS: Frailty index (FI) based on the accumulation of deficits in 40 items.
resultsThe results show that education is protective against frailty in all countries (a decrease of 1.1 pp. in Switzerland to 5.7 pp. in Slovenia, all p < 0.001). In most countries, women are frailer than men and migrant individuals have higher levels of frailty than non-migrants. FI trajectories showed heterogeneity across countries. The quantiles for women and migrants suggest frailer trajectories than men and non-migrants respectively.
conclusionsFindings from this cross-national comparison provide a framework within which the longitudinal norms of frailty trajectories from different countries can be interpreted.
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