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A cross-cultural investigation of the conceptualisation of frailty in northern Tanzania

Lookup NU author(s): Grace LewisORCiD, Dr Matthew Breckons



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Copyright © The Author(s), 2021. Published by Cambridge University Press.Frailty prevalence is higher in low- and middle-income countries (LMICs) compared with high-income countries when measured by biomedical frailty models, the most widely used being the frailty phenotype. Frailty in older people is becoming of global public health interest as a means of promoting health in old age in LMICs. As yet, little work has been done to establish to what extent the concept of frailty, as conceived according to 'western' biomedicine, has cross-cultural resonance for a low-income rural African setting. This study aimed to investigate the meaning of frailty contextually, using the biomedical concept of the frailty phenotype as a framework. Qualitative interviews were conducted with a purposive sample of older adults, their care-givers and community representatives in rural northern Tanzania. Thirty interview transcripts were transcribed, translated from Kiswahili to English and thematically analysed. Results reveal that despite superficial similarities in the understanding of frailty, to a great extent the physical changes highlighted by the frailty phenotype were naturalised, except when these were felt to be due to a scarcity of resources. Frailty was conceptualised as less of a physical problem of the individual, but rather, as a social problem of the community, suggesting that the frailty construct may be usefully applied cross-culturally when taking a social equity focus to the health of older people in LMICs.

Publication metadata

Author(s): Lewis EG, Rogathi J, Kissima J, Breckons M, Lee R, Urasa S

Publication type: Review

Publication status: Published

Journal: Ageing & Society

Year: 2023

Volume: 43

Issue: 1

Pages: 127-160

Print publication date: 01/01/2023

Online publication date: 22/04/2021

Acceptance date: 11/03/2021

ISSN (print): 0144-686X

ISSN (electronic): 1469-1779

Publisher: Cambridge University Press


DOI: 10.1017/S0144686X21000520