Proportion of frailty across eGFR categories and their association with patient-reported outcomes: insights from the SHARE database

BACKGROUND: Frailty is a common condition among older adults with high prevalence within the dialysis population, but there has not been a large-scale investigation among European older adults with reduced eGFR. The objectives of this study are to describe the proportion of frailty among adults aged ≥50 years with reduced eGFR in the Survey of Health, Ageing and Retirement in Europe (SHARE) and assess the association between frailty, eGFR, and patient-reported outcomes. METHODS: We used cross-sectional data from Wave 6 of SHARE. Participants were categorized using CKD-EPI 2012 cystatin-based equations. Frailty was measured with the Fried's Frailty Scale. RESULTS: A total of 23,028 participants with a mean age of 68 years were included in the analysis. The proportion of pre-frailty/frailty was higher in the lower eGFR categories: 49% of those with eGFR≥60 ml/min/1.73m2, 75.0% of those with eGFR:45-59 ml/min/1.73m2 (G3a), 87.3% of eGFR:30-44 ml/min/1.73m2 (G3b), and 92.9% of eGFR≤29 ml/min/1.73m2 (G4/G5) were classified as pre-frail or frail. GFR categories were associated with frailty categories after adjustment for age and sex. Compared to subjects with eGFR≥60 ml/min/1.73m2, those in the G3a, G3b, and G4/G5 categories had 1.18, 1.28 and 2.11 times higher odds for worse self-rated health, respectively. Quality of life scores were lower in participants with reduced eGFR, while impairments in instrumental activities of daily living were more common. CONCLUSIONS: Increased frailty levels are common in adults with reduced eGFR. Lower eGFR categories were consistently associated with frailty and greater IADL impairment. Geriatric assessments should be considered in this population.