# Comparison of Frailty and Autonomy Levels in Older Adults According to Place of Residence

## TL;DR

Older adults living in the community have higher autonomy than those in institutions, though frailty levels are similar, with men showing a stronger link between frailty and loss of autonomy.

## Contribution

The study reveals a health-survival paradox in men and emphasizes the role of place of residence in functional autonomy.

## Key findings

- Community-dwelling older adults showed significantly higher autonomy than institutionalized individuals.
- Frailty levels were not significantly different between community and institutionalized groups.
- Men exhibited a stronger negative correlation between frailty and autonomy compared to women.

## Abstract

Background/Objectives: The present study aimed to compare levels of frailty and functional independence in older adults according to their place of residence and to analyze the associations between age, frailty, and autonomy, considering sex. Methods: A cross-sectional analytical study was conducted with a sample of 77 older adults (80.16 ± 8.68 years), divided into community-dwelling (n = 38) and institutionalized (n = 39) participants. Data collection included sociodemographic characterization and the assessment of frailty and autonomy. Results: Older adults in the community showed significantly higher levels of autonomy (94.21 ± 10.81) compared to those who were institutionalized (75.53 ± 23.21; p < 0.001). No significant differences were found in frailty levels between the groups (p = 0.674). Correlation analysis revealed a strong negative association between frailty and autonomy, which was more pronounced in institutionalized older adults (r = −0.64) and in males (r = −0.72). Age was only correlated with the loss of autonomy in men (r = −0.43). Conclusions: Place of residence is a critical determinant of functional autonomy but not of perceived frailty. The results highlight a health-survival paradox, where men exhibit a more abrupt functional decline associated with frailty. The implementation of gerontomotricity programs in residential care facilities is suggested to mitigate learned dependency.