Modifiable factors associated with frailty among indigenous older adults in southern Taiwan: a community-based cross-sectional study

Abstract

Background Frailty is a major public health challenge among older adults. Indigenous populations experience poorer health outcomes and a greater burden of frailty than the general population. However, evidence on modifiable factors associated with frailty in Taiwanese Indigenous older adults remains limited. This study examined the associations between nutritional status, anthropometric characteristics, physical function, physical activity, and frailty among Indigenous older adults living in rural communities. Methods A community-based, cross-sectional study was conducted among 117 Indigenous older adults aged ≥55 years attending Indigenous Cultural Health Stations. As the outcome measure, frailty was assessed using the Chinese version of the Clinical Frailty Scale (CFS-C). Predictor variables included nutritional status measured using the Mini Nutritional Assessment–Short Form, anthropometric characteristics (body mass index and calf circumference), physical function (handgrip strength and preferred gait speed), and physical activity assessed using the International Physical Activity Questionnaire–Short Form. Multivariable binary logistic regression was performed to identify factors independently associated with frailty. Results Of the 117 participants, 27 (23.1%) were classified as frail (CFS-C ≥ 4). Compared with non-frail participants, frail participants were older and had slower preferred gait speed, weaker handgrip strength, and lower physical activity levels (all p < 0.01). After adjustment for age, sex, handgrip strength, preferred gait speed, and physical activity, faster preferred gait speed (OR = 0.266, 95% CI = 0.139–0.510, p < 0.001) and higher physical activity (OR = 0.998, 95% CI = 0.996–0.999, p = 0.007) remained independently associated with lower odds of frailty. Conclusion Preferred gait speed and physical activity were independently associated with lower odds of frailty among Indigenous older adults. Routine gait speed assessment and attention to physical activity in Indigenous Cultural Health Stations may support frailty identification and community-based health promotion.