Association of Life-Course Neighborhood Deprivation With Frailty and Frailty Progression From Ages 70 to 82 Years in the Lothian Birth Cohort 1936

Neighbourhood features have been postulated as key predictors of frailty. However, evidence is mainly limited to cross-sectional studies without indication of long-term impact. We explored how neighbourhood social deprivation (NSD) across the life course is associated with frailty and frailty progression among older Scottish adults. Participants (n=323) were from the Lothian Birth Cohort 1936 with historical measures of NSD in childhood (1936-1955), young adulthood (1956-1975), and mid-to-late adulthood (1976-2014). Frailty was measured five times between the ages of 70 and 82 years using the Frailty Index. Confounder-adjusted life-course models were assessed using a structured modelling approach; associations were estimated for frailty at baseline using linear regression, and for frailty progression using linear mixed-effects models. Accumulation was the most appropriate life-course model for males; greater accumulated NSD was associated with higher frailty at baseline (b=0.017; 95%CI: 0.005-0.029). Among females, mid-to-late adulthood sensitive period was the best-fit life-course model and higher NSD in this period was associated with widening frailty trajectories (b=0.005; 95%CI: 0.0004-0.009). This is the first investigation of the life-course impact of neighbourhood deprivation on frailty in a cohort of older adults. Policies designed to address neighbourhood deprivation and inequalities across the full life course may support healthy ageing.