Prevalence of frailty and its association with Vitamin D levels, a cross-sectional study conducted among elderly patients at Masaka Regional Referral Hospital, Central Uganda.

Abstract

Background:

Frailty is a syndrome of decreased physiological reserve that predisposes older adults to adverse health outcomes. Vitamin D has emerged as a potential biomarker, but data are scarce in Ugandan hospital settings. This study assessed the prevalence of frailty and its association with serum 25‑hydroxyvitamin D levels, along with other associated factors, among elderly patients at Masaka Regional Referral Hospital (MRRH).

Methods and Materials:

384 patients aged ≥ 60 years attending in‑ and outpatient services at MRRH were consecutively recruited. Frailty was measured using the Fried Phenotypic Scale, which is used to assess frailty based on 5 components: unintentional weight loss, exhaustion, low physical activity, slowness, and grip strength. It categorizes a participant as non‑frail (score 0), pre‑frail (score 1-2), or frail (score 3 and above). Serum 25-hydroxyvitamin D was quantified and classified as deficient (≤ 20 ng/mL), insufficient (21–29 ng/mL), or sufficient (≥ 30 ng/mL). Data were collected using a structured questionnaire. Multivariable Poisson regression with robust error variance estimated adjusted prevalence ratios (aPR) for frailty determinants.

Results:

Participants had a median age of 66.5 years (IQR 62–74.5); 54.4% were female. Vitamin D deficiency and insufficiency were present in 44.8% and 32.6% of participants, respectively. Overall frailty prevalence was 58.3% (95% CI 53.3–63.2%), with 40.9% pre‑frail and 0.8% non‑frail. Independent associated factors of frailty included no education (aPR 1.62; p = 0.035) or primary education only (aPR 1.59; p = 0.034), lack of physical activity (aPR 1.61; p = 0.002), self‑reported depression (aPR 1.33; p = 0.002), and comorbidities (aPR 4.59; p = 0.022). Nutritional factors also contributed: vitamin D deficiency (aPR 5.13; p < 0.001) and insufficiency (aPR 2.87; p = 0.003), processed‑food consumption (aPR 1.77; p < 0.001), and hypomagnesemia (aPR 1.15; p = 0.029).

Conclusion:

Frailty affects nearly three‑fifths of elderly patients at MRRH, with vitamin D deficiency emerging as the strongest modifiable predictor alongside education, physical inactivity, depression, comorbidities, diet, and magnesium status.

Recommendation:

Integrating routine frailty and vitamin D screening into geriatric care, paired with targeted supplementation, may mitigate frailty and its sequelae among the elderly.