Associations between living alone, social interactions, and physical performance differ by sex: Results from the Baltimore Hip Studies

Abstract

BackgroundThere is mixed evidence on whether living arrangements and social interactions are associated with poorer health outcomes after hip fracture repair. Distinct social profiles among male and female older adults may explain some of the differences. However, prior studies did not evaluate these differences by sex. This article aims to assess if the associations between living alone, social interaction, and physical performance differ by sex among hip fracture survivors.MethodsThis prospective cohort study is part of the Baltimore Hip Studies seventh cohort, with 168 male and 171 female hip fracture patients assessed at baseline (≤22 days after hospitalization) and at 2, 6, and 12 months post admission. Living arrangements and interaction with children or siblings and others in the past 2 weeks were collected at all visits. Physical performance was measured in the follow‐up visits with the Short Physical Performance Battery (SPPB). Linear mixed models tested associations of living alone and social interaction with SPPB over time adjusted for age, education, comorbidities, physical functioning pre‐fracture, cognitive function, self‐rated health, and time.ResultsFor men only, living alone was associated with worse performance (0.7 points lower SPPB scores, p = 0.05). Higher social interaction was associated with 0.8 and 1.2 point higher SPPB scores for men and women, respectively (p < 0.05). Visiting with friends was significantly associated with better function among males, while visiting with children or siblings was associated with worse SPPB among females.ConclusionsLiving arrangements and types of social interaction are differentially associated with physical function for older men and women. Screening for social isolation/integration and including interventions that promote social interaction and participation should be considered in healthcare programs for hip fracture survivors.

Associations of sex, Alzheimer's disease and related dementias, and days alive and at home among older Medicare beneficiaries recovering from hip fracture

“…After controlling for previously identified sex differences in hip fracture outcomes including age at time of fracture, comorbidities, and prior days at home, did not change the observed sex differences. Differences in aging in place among males could reflect illness severity, poorer management or pre‐existing function or medical comorbidities, or differences in social supports available to support recovery from a new disability 34,35 . These factors may contribute to the divergence by sex seen in Figure 1.…”

Effect of a Multicomponent Intervention with Tele-Rehabilitation and the Vivifrail© Exercise Programme on Functional Capacity after Hip Fracture: Study Protocol for the ActiveFLS Randomized Controlled Trial

“…These interventions are based on multiple factors related to functional recovery after a hip fracture, including biological characteristics such as age, sex, comorbidities, cognitive status, nutritional state and biochemical parameters [ 12 ]. Nowadays, social support is also significantly associated with this recovery [ 13 ], so tele-rehabilitation may provide essential support in this context [ 14 ].…”