Usher Institute

England’s oldest became frailer during austerity

The speed at which England’s oldest adults became frailer accelerated during the UK Government’s era of austerity politics, according to a new study.

Walking frame in corridor of nursing home with windows on left hand side and a closed door at the end of the corridor

Researchers from the Advanced Care Research Centre (ACRC) say that the rate of frailty in people aged 85 and over in England increased 50 per cent faster per year between 2012 and 2018 compared with the preceding eight years. 

The impact of frailty – a decline in a person’s mental and physical resilience to illness and injury – on the oldest in society must be considered should any new austerity measures be introduced, experts warn.   

Frailty index 

Researchers Carys Pugh, Chima Eke, Sohan Seth, Bruce Guthrie and Alan Marshall, all from the ACRC, analysed data from 16,410 people in the English Longitudinal Study of Ageing, a nationally representative sample of the English population aged at least 50 between 2002 and 2018.  

Researchers combined this with the frailty index, which captures broad age-related declines in functional ability and physical and mental health. 

The sample had an average age of 67 years and an average frailty index score of 0.15 (on a scale of 0 to 1, with 1 being maximum frailty). 

Researchers found that frailty index scores increased more rapidly across all genders and socio-economic groups during the study period but it was particularly noticeable in the oldest people. 

Improvements lost 

Frailty levels dropped in the 2000s but experienced a steep increase in the 2010s, when the UK government introduced a wave of public spending cuts in response to the 2008 global financial crisis, with all ages losing improvements that had been made. 

For the oldest, the improvements were lost entirely, and they were frailer than those of the same age living in the prior decade, experts say. 

The researchers did not examine why public sector cuts might cause these changes, but they say the findings correspond with the flattening of life expectancy seen in the 2010s, with higher mortality rates particularly seen in the eldest. 

A key implication of this research should be a recognition that public spending reductions likely have negative impacts on health and, in turn, mortality, particularly amongst the oldest in society. Frailty normally increases with age but as we emerge from the pandemic and into a cost of living crisis, any new austerity measures need careful consideration given their potential impact on long-term health, especially among the eldest who appear particularly vulnerable.

Dr Carys PughResearch Fellow, Advanced Care Research Centre, Usher Institute 

Further information 

Read the paper in the journal PLOS ONE 

Read The Guardian article "Frailty in older people rose sharply during austerity years, study reveals"

Learn more about the Advanced Care Research Centre 

View Carys Pugh’s profile 

View Sohan Seth’s profile 

View Bruce Guthrie’s profile 

View Alan Marshall’s profile 

Cite as 

Pugh C, Eke C, Seth S, Guthrie B, Marshall A (2024) Frailty before and during austerity: A time series analysis of the English Longitudinal Study of Ageing 2002–2018. PLOS ONE 19(2): e0296014.  

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