Prevalence and associations of frailty in residents of Australian aged care facilities: findings from a retrospective cohort study



Studies conducted among older people have shown that frailty is a common condition associated with an array of adverse outcomes. The aims of this study were to identify the prevalence and associations of frailty in older people residing in several aged care facilities located in Queensland, Australia.


The database used for this study was drawn from the Aged Care Funding Instrument (ACFI) database of an Australian aged care provider, and contained data from ten aged care facilities in Queensland, Australia. A modification of an eFI originally developed by Clegg and colleagues and based on Rockwood’s Frailty Index (FI) of cumulative deficits was used to identify frailty.


In total, 592 participants aged 75 years and over were included in the study (66.6% female). Median (IQR) age was 88.0 (9.0) years. Frailty prevalence among the sample was 43.6%, with 46.3% pre-frail and 10.1% not frail. In a multivariate logistic regression analysis incorporating three different models, frailty was significantly associated with three ACFI domains (Nutrition, Depression and Complex Health Care), along with facility size, consistently across two models. In the third model, frailty was also significantly associated with arthritis, diabetes, hypertension, osteoporosis and vision problems, along with male gender.


There is a need to develop frailty identification and management programs as part of standard care pathways for older adults residing in aged care facilities. Aged care facilities should consider regular frailty screening in residential aged care residents, along with interventions addressing specific issues such as dysphagia and depression.

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Lutheran Services Queensland provided the main source of support for this work. ED received support from an Australian National Health and Medical Research Council (NHMRC) Grant: #1112672. RA is also supported by the NHMRC Centre of Research Excellence in Transdisciplinary Frailty Research to Achieve Healthy Ageing (Grant:#1102208).

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Correspondence to R. C. Ambagtsheer.

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Conflict of interest

CS and ED are employees of Lutheran Services Queensland.

Statement of human and animal rights

Ethics approval for this study was sought from the Human Research Ethics Committee of Torrens University Australia (application H11/19) and declared exempt under National Statement, 5.1.22 (secondary use of de-identified administrative data). The study adhered to the Australian National Statement on Ethical Conduct in Human Research.

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Due to the pragmatic nature of the study and administrative data source, a waiver of obtaining consent was approved by the Human Research Ethics Committee of Torrens University Australia.

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Ambagtsheer, R.C., Beilby, J., Seiboth, C. et al. Prevalence and associations of frailty in residents of Australian aged care facilities: findings from a retrospective cohort study. Aging Clin Exp Res 32, 1849–1856 (2020).

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  • Frailty
  • Residential facilities
  • Geriatric assessment