Frailty among middle-aged and older Canadians: Population norms for the frailty index using the Canadian Longitudinal Study on Aging

Abstract
Background:frailty is a public health priority now that the global population is ageing at a rapid rate. A scientifically soundtool to measure frailty and generate population-based reference values is a starting point.Objective:in this report, our objectives were to operationalize frailty as deficit accumulation using a standard frailty index(FI), describe levels of frailty in Canadians≥45 years old and provide national normative data.Design:this is a secondary analysis of the Canadian Longitudinal Study on Aging (CLSA) baseline data.Setting/participants:about 51,338 individuals (weighted to represent 13,232,651 Canadians), aged 45–85 years, from thetracking and comprehensive cohorts of CLSA.Methods:after screening all available variables in the pooled dataset, 52 items were selected to construct an FI. Descriptivestatistics for the FI and normative data derived from quantile regressions were developed.Results:the average age of the participants was 60.3 years (95% confidence interval [CI]: 60.2–60.5), and 51.5% were female(95% CI: 50.8–52.2). The mean FI score was 0.07 (95% CI: 0.07–0.08) with a standard deviation of 0.06. Frailty was higheramong females and with increasing age, and scores>0.2 were present in 4.2% of the sample. National normative data wereidentified for each year of age for males and females.Conclusions:the standardized frailty tool and the population-based normative frailty values can help inform discussionsabout frailty, setting a new bar in the field. Such information can be used by clinicians, researchers, stakeholders and thegeneral public to understand frailty, especially its relationship with age and sex.