LAUSR

Abstract Introduction: We sought to understand regional variation of frailty across health service areas (HSAs) in Northern and Central California among older adults with benign urological conditions. Methods: This retrospective study utilizes the University of California, San Francisco Geriatric Urology Database, which includes adults ≥65 years old with benign urological conditions who underwent a Timed Up and Go Test (TUGT) between December 2015 and June 2020. The TUGT is a validated proxy for frailty, whereby a TUGT ≤10 seconds represents robust individuals and a TUGT >10 seconds represents prefrail and frail individuals. Subjects were assigned to the HSA wherein they live, and HSAs were stratified by mean TUGT scores. Analyses were conducted at the HSA level. Characteristics associated with prefrail/frail HSAs were identified using multivariable logistic regression. Least square means were used to determine variation in adjusted mean TUGT scores. Results: A total of 2,596 subjects were stratified into 69 HSAs in Northern and Central California. Twenty-one HSAs were categorized as robust and 48 HSAs were categorized as prefrail/frail. Prefrail/frail HSAs were significantly associated with older age (adjusted odds ratio [aOR] 4.03, CI 3.29–4.94, p <0.001), female sex (aOR 1.10, CI 1.07–1.11, p <0.001), non-White race (aOR 1.12, CI 1.10–1.14, p <0.001), underweight body mass index (BMI; aOR 1.14, CI 1.07–1.22, p <0.001) and obese BMI (aOR 1.06, CI 1.04–1.08, p <0.001). There was a 1.7-fold difference in mean TUGT values across HSAs. Conclusions: Older age, non-White race, and underweight and obese BMIs are associated with prefrail/frail HSAs. Further investigation into health disparities as they pertain to geography and frailty is needed to expand upon these findings.