Abstract

We investigated the regional characteristics of COVID-19 pandemic-associated frailty. This three-year repeated cross-sectional study compares data from 2019 before the pandemic with information from 2020–2021 during the pandemic. Out of the 5,552 individuals targeted, a total of 3,168 people were included in the analysis after applying the exclusion criteria. In each study year, we used the Kihon Check list (KCL) to assess the frailty status of all older individuals aged 70 and 75 years living in a city in Tochigi Prefecture. The KCL categorized individual participants' status as robust, pre-frailty, or frailty. Participants were also classified into three groups based on population density: urban, suburban, and rural. The chi-square test was employed for all statistical analyses. The frailty and pre-frailty groups grew significantly in urban and suburban areas, while rural areas showed no such increase. Examining specific KCL question items, we observed a significant increase in No. 4 (visiting friends) only in urban and suburban areas, whereas No. 17 (going out less) showed a significant increase across all three areas. This research shows that high population density areas were more susceptible to COVID-19 pandemic-associated frailty, while rural areas were less susceptible.