Sex Differences in Comorbidity and Frailty in Europe

Int J Public Health. 2019 Sep;64(7):1025-1036. doi: 10.1007/s00038-019-01270-9. Epub 2019 Jun 24.

Abstract

Objectives: To examine sex differences in prevalent comorbidity and frailty across age and European regions.

Methods: This is a cross-sectional study based on 113,299 Europeans aged 50+ participating in the Survey of Health, Ageing and Retirement in Europe from 2004-2005 to 2015. Sex differences in the Comorbidity Index and the Frailty Phenotype were investigated using ordinal logistic regressions.

Results: European women had generally higher odds of prevalent comorbidity (OR 1.11, 95% CI 1.07-1.15) and frailty (OR 1.56, 95% CI 1.51-1.62). Sex differences increased with advancing age. No overall sex difference in comorbidity was found in Western Europe, but women had more comorbidity than men in Eastern (OR 1.30, 95% CI 1.18-1.44), Southern (OR 1.23, 95% CI 1.15-1.30), and Northern (OR 1.08, 95% CI 1.01-1.16) Europe. Women were frailer than men in all regions, with the largest sex difference in Southern Europe (OR 1.84, 95% CI 1.72-1.96).

Conclusions: European women are frailer and have slightly more comorbidity than European men lending support for the male-female health survival paradox.

Keywords: Comorbidity; Europe; Frailty; SHARE; Sex differences.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Comorbidity*
  • Cross-Sectional Studies
  • Europe / epidemiology
  • Female
  • Frail Elderly / statistics & numerical data*
  • Frailty / epidemiology*
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Sex Factors
  • Socioeconomic Factors