Introduction: It is well known that older European women live longer than men, but spend more years and a larger proportion of life expectancy (LE) with disability. Whether this also applies to frailty is unknown. We aimed to compare LE in frailty states (non-frail, pre-frail and frail) at older ages between European countries.
Methods: Age- and sex-specific prevalence of frailty states based on the Frailty Instrument for primary care of the Survey of Health, Ageing and Retirement in Europe (SHARE-FI) were calculated from SHARE wave 4 for the 15 participating countries (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Hungary, Italy, Netherlands, Poland, Portugal, Slovenia, Spain, and Sweden). These countries represent 86% of the non-institutionalised population aged 50+ of the EU27 in 2010. LE in each frailty state for each country and sex were calculated using Sullivan's method with 2010 life tables obtained from Eurohex (http://www.eurohex.eu).
Results: Sweden had the longest LE non-frail at age 75 in men (8.6 years) while Hungary had the shortest (3.4 years). Danish women had the longest LE non-frail (6.8 years) and Polish women the shortest (2.2 years). Significant sex differences in LE non-frail were found in the Netherlands, Poland, Portugal, Spain and Sweden and in LE frail in all countries except Denmark and Sweden. Overall EU27 women spent more absolute years and a greater proportion of LE frail and pre-frail at every age. For EU27 men LE frail was constant (2.3 years) up to age 80. By age 80 LE frail exceeded LE non-frail but only for women.
Conclusions: In most European countries women spend significantly more years pre-frail, as well as frail, at all ages. We found substantial disparities in LE in frailty states between countries. Exploring the factors associated with these disparities could aid the design of interventions to prevent frailty.