Frailty among older people during the first wave of the Covid-19 pandemic in the Netherlands

Background:
Restrictive measures due to the Corona pandemic may cause problems in the domains of physical, social and psychological functioning, which may result in increased frailty. In this study we aimed to assess prevalence and characteristics of frailty and to identify explanatory variables of frailty during the first Corona wave in Dutch people aged ≥65 years. 
Methods: 
We performed a cross-sectional study of people aged ≥65years with data from the Lifelines Covid-19 Cohort Study. The Groningen Frailty Indicator (GFI) was used; a score ≥4 indicated frailty. Frailty was characterized by the domains of the GFI (physical, cognitive, social, and psychological). Demographic, health and lifestyle variables were studied for their association with frailty with univariate and multivariate binary logistic regression analyses. 
Results: 
Frailty was present in 13% of the 11,145 participants. Most GFI items (52%) were scored within the social domain. Higher age, more co-morbidities, physical discomfort, problems sleeping, change in appetite or weight and/or smoking were associated to increased odds of being frail. A satisfactory quality of life and/or sufficient physical activity were associated with lower odds of being frail. Conclusion: During the first wave of the Corona pandemic, frailty is a considerable problem in the Netherlands, with one out of eight older people being frail. Problems in the social domain and to a lesser extent in the physical domain, characterized GFI scores in both frail and non-frail persons.  Explanatory variables for frailty were related to age, social resources, physical wellbeing and quality of life and lifestyle.