Dataset Information

Frailty Combined with Loneliness or Social Isolation: An Elevated Risk for Mortality in Later Life.

ABSTRACT: Background/objectives: Frailty, loneliness, and social isolation are all associated with adverse outcomes in older adults, but little is known about their combined impact on mortality.

Design: Prospective cohort study.

Setting: The Longitudinal Aging Study Amsterdam.

Participants: Community-dwelling older adults aged 65 and older (n = 1,427).

Measurements: Frailty was measured with the frailty phenotype (Fried criteria). Loneliness was assessed with the De Jong Gierveld Loneliness Scale. Social isolation was operationalized using information on partner status, social support, and network size. Two categorical variables were created, for each possible combination regarding frailty and loneliness (FL) and frailty and social isolation (FS), respectively. Mortality was monitored over a period of 22?years (1995-2017). Survival curves and Cox proportional hazard models were used to study the effects of the FL and FS combinations on mortality. Analyses were adjusted for sociodemographic factors, depression, chronic diseases, and smoking.

Results: Frailty prevalence was 13%, and 5.9% of the sample were frail and lonely, and 6.2% frail and socially isolated. In fully adjusted models, older adults who were only frail had a higher risk of mortality compared with people without any of the conditions (hazard ratio [HR] range = 1.40-1.48; P?FL = 1.83; 95% confidence interval [CI] = 1.42-2.37; HR_FS = 1.77; 95% CI = 1.36-2.30). Sensitivity analyses using a frailty index based on the deficit accumulation approach instead of the frailty phenotype showed similar results, confirming the robustness of our findings.

Conclusion: Frail older adults are at increased risk of mortality, but this risk is even higher for those who are also lonely or socially isolated. To optimize well-being and health outcomes in physically frail older adults, targeted interventions focusing on both subjective and objective social vulnerability are needed.

SUBMITTER: Hoogendijk EO

PROVIDER: S-EPMC7689758 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Frailty Combined with Loneliness or Social Isolation: An Elevated Risk for Mortality in Later Life.

Hoogendijk Emiel O EO Smit Annelot P AP van Dam Carmen C Schuster Noah A NA de Breij Sascha S Holwerda Tjalling J TJ Huisman Martijn M Dent Elsa E Andrew Melissa K MK

Journal of the American Geriatrics Society 20200723 11

<h4>Background/objectives</h4>Frailty, loneliness, and social isolation are all associated with adverse outcomes in older adults, but little is known about their combined impact on mortality.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>The Longitudinal Aging Study Amsterdam.<h4>Participants</h4>Community-dwelling older adults aged 65 and older (n = 1,427).<h4>Measurements</h4>Frailty was measured with the frailty phenotype (Fried criteria). Loneliness was assessed with the De Jong Gie ...[more]

PMID: 32700319

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Project description:BackgroundPhysical frailty is a common characteristic of older people with the ageing process and has been viewed as a major public health issue. The longitudinal association between different social engagement and physical frailty among older people has not been explored adequately in China. Marital status forms a critical context for the link between social engagement and frailty among older people, which might constitute a moderating process. The purpose of the present study is to investigate the longitudinal association between social engagement and the changes in physical frailty among Chinese older adults, and to examine whether the association between social engagement and frailty differs by marital status.MethodsThe data use in this study were from the data from the China Health and Retirement Longitudinal Study aged 60+ years from 2011 to 2015. A total of 6575 respondents who participated in at least one follow-up wave were included in the analysis. The relationship between social engagement and changes in frailty over time, and the moderating role of marital status were estimated using individual fixed-effects models. Sensitive analyses were conducted to test the robustness of the results.ResultsAfter adjusting the confounders, participants who interact with friends (Coef: -1.309, P < 0.001), engaging in hobby groups (Coef: -1.189, P < 0.001), engaging in sports groups (Coef: -0.945, P = 0.001), and volunteering (Coef: -1.957, P = 0.001) with a frequency of almost daily had a significantly lower frailty risk than participants who never engaging in those activities. The association between frequent engaging in hobby groups and physical frailty was strongest for unmarried than married older adults (Coef: -1.325, P = 0.031).ConclusionsFrequent social engagement might help to decrease the risk of frailty in the Chinese older population. This finding has important implications for public health policy and encourages the incorporation of a broad range of social engagement into the daily lives of older individuals. Specially, encouraging unmarried older adults to engage in intellectual activities, such as playing chess or Mahjong with others, may be an effective way to reduce physical frailty.

Dataset Information

Frailty Combined with Loneliness or Social Isolation: An Elevated Risk for Mortality in Later Life.

Publications

Frailty Combined with Loneliness or Social Isolation: An Elevated Risk for Mortality in Later Life.

Similar Datasets

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