The association between frailty and quality of life in elderly population in Southern Iran: Findings from the Bushehr Elderly Health Program

Yasaman Zarinfar; Nekoo Panahi; Erfan Jannatalipour; Marjan Hosseinpour; Gita Shafiee; Mahnaz Sanjari; Iraj Nabipour; Noushin Fahimfar

doi:10.1186/s12877-026-07791-2

The association between frailty and quality of life in elderly population in Southern Iran: Findings from the Bushehr Elderly Health Program

BMC Geriatr. 2026 Jun 8. doi: 10.1186/s12877-026-07791-2. Online ahead of print.

Authors

Yasaman Zarinfar^{1

2}, Nekoo Panahi^{3

4}, Erfan Jannatalipour⁵, Marjan Hosseinpour^{1

6}, Gita Shafiee⁷, Mahnaz Sanjari¹, Iraj Nabipour⁸, Noushin Fahimfar^{1

6}

Affiliations

¹ Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
² School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. nekoo.panahi@gmail.com.
⁴ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. nekoo.panahi@gmail.com.
⁵ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁶ Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
⁷ Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁸ The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.

PMID: 42260390
DOI: 10.1186/s12877-026-07791-2

Abstract

Background: Frailty is increasingly recognized as a common geriatric syndrome, particularly in rapidly ageing populations. Substantial evidence suggests that frailty is associated with poorer quality of life (QoL). However, in Iran, the relationship between frailty and both physical and mental QoL remains underexplored in community-dwelling older adults.

Methods: This cross-sectional study used data from 2,367 individuals aged 60 years or older (mean age: 69.3 ± 6.3 years) enrolled in the Bushehr Elderly Health Program, using a cluster random sampling approach. Frailty was assessed using the Fried frailty phenotype, which classified participants as non-frail, pre-frail, or frail. QoL was measured using the 12-item Short Form Health Survey (SF-12), which provides physical component summary (PCS) and mental component summary (MCS) scores. Covariates included age, sex, education, marital status, body mass index, number of physical and neuropsychiatric comorbidities, and living arrangements. Hierarchical linear regression and logistic regression were performed to assess the independent association between frailty status and QoL outcomes.

Results: In this community-based sample, the prevalence of frailty was 8.0% (n = 191). Frail participants had lower mean PCS and MCS scores than non-frail individuals (PCS: 32.3 ± 7.85 vs. 45.8 ± 6.43; MCS: 42.1 ± 7.96 vs. 47.6 ± 7.49; both p < 0.001). In fully adjusted linear regression models, frailty status was independently associated with lower PCS scores (frail: β = -9.51, 95% CI: -10.70 to -8.31; pre-frail: β = -4.41, 95% CI: -5.66 to -3.16) compared with non-frail status. Pre-frailty was also associated with lower MCS scores (β = -1.15, 95% CI: -1.94 to -0.36), whereas the association between frailty and MCS did not reach statistical significance (β = -0.92, 95% CI: -2.44 to 0.60). In logistic regression, frail individuals had higher odds of being in the lowest PCS quartile (adjusted odds ratio [aOR] = 13.77, 95% CI: 8.81-21.52) and the lowest MCS quartile (aOR = 1.56, 95% CI: 1.02-2.39).

Conclusion: Frailty is common among Iranian older adults and is independently associated with poorer physical QoL and, to a lesser extent, mental QoL. These findings support the need for targeted screening and multidomain interventions.

Keywords: Comorbidity; Elderly; Frailty; Iran; Quality of Life.