Aims: Retirement villages (RV) residents are thought to live in relatively age-friendly environments. Many RVs have facilities and resources for healthcare, home-based supports and opportunities for physical and social activity. Living within such environments may influence changes in frailty.
Methods: Longitudinal cohort study of 578 residents recruited from 33 RVs. Frailty by interRAI-derived frailty index (FI) was measured using resident data at baseline and 2.5 years later. Village-level data was collected at baseline. Analysis of factors associated with worsening frailty or death was performed with multivariable logistic regression.
Results: Follow-up data was available for 525 residents: 289 (55.0%) stayed within same frailty category, 23 (4.4%) improved, 166 (31.6%) worsened in frailty category and 47 (9.0%) had died. Age >90 at baseline (OR=3.34, 95%CI=1.61-6.93, p=0.001), poor/fair quality of life (OR=2.94, 95%CI=1.35-6.40, p=0.007), participation in social activities of long-standing interest in the last 30 days (OR=1.99, 95%CI=1.06-3.71 p=0.03), and charitable trust-owned villages (OR=1.71, 95%CI=1.06-2.77, p=0.03) were associated with higher odds of worsening frailty category or death. There was borderline significance with not visiting a dentist in the past 12 months (OR=1.43, 95%CI=0.98, 2.08, p=0.07), with significance found on sensitivity analysis (OR=1.51, 95%CI 1.05-2.17, p=0.03).
Conclusions: Individual and RV-level factors were associated with worsening frailty or death, some of which are potentially modifiable. Research addressing how differences between RV ownership models influences frailty is needed. Understanding how the wider social and physical environment influences frailty is essential for designing frailty prevention strategies at the neighborhood level and in the creation of frailty-friendly environments.