Abstract
BACKGROUND: Frailty is a major contributor to poor quality of life among older people in Sub-Saharan Africa. As the population of older people in the region increases, frailty continues to adversely affect individuals, their families, communities, and healthcare systems. Despite this growing impact, the specific health deficits that contribute to frailty in the region remain poorly understood. This study examines the health deficits that contribute to frailty among older people in Côte d'Ivoire. METHODS: This study utilized data from 1,017 older people across three regions of Côte d'Ivoire. Frailty was assessed using a 30-item Frailty Index, with a threshold of 0.21 used to classify frailty status. Descriptive statistics were used to estimate the prevalence and intensity of frailty. The Kruskal-Wallis test was applied to compare frailty scores across regions, and the Wald test was used to assess differences in the contribution of individual health deficits. Subgroup analyses were conducted by gender, age group, and region to explore variations in frailty patterns. RESULTS: Among 1,017 participants (mean age: 62.1 years), 59.3% were classified as frail, with a higher prevalence in females (70.5%) than males (48.0%). Frailty increased with age, peaking at 74.6% among the oldest group. The intensity of frailty was 39.4%, higher among females (40.7%) and the oldest participants. Fatigue, pain, weakness, and poor physical health accounted for the largest proportion of deficits (36.3%). Multivariate tests showed significant subgroup differences in deficit patterns. Wilks' lambda for gender (λ = 0.7952), age (λ = 0.7888), and region (λ = 0.7990) were all significant (p < 0.001), supported by Roy's largest root and Wald tests. CONCLUSION: The higher frailty burden among women and its progressive increase with age highlight the need for early, gender-sensitive screening approaches. Preventive strategies should begin in midlife and focus on risk factors linked to frailty, such as low physical activity and poorly managed chronic conditions. This will help to slow frailty progression in later life.