Frailty and Social Isolation: Comparing the Relationship between Frailty and Unidimensional and Multifactorial Models of Social Isolation

Abstract

Objective: The aim of the study was to compare uni- and multidimensional models of social isolation to improve the specificity of determining associations between social isolation and frailty. Methods: The study included participants aged ≥60 years from the English Longitudinal Study of Ageing assessed for social isolation and frailty (frailty index and Fried phenotype) over a 4-year period. Factor analysis assessed whether social isolation was multidimensional. Multiple regression analysis was used to assess specificity in associations between social isolation and frailty over time. Results: Social isolation comprises social isolation from nuclear family, other immediate family, and wider social networks. Over time, social isolation from a wider social network predicted higher frailty index levels, and higher frailty index and Fried phenotype levels predicted greater social isolation from a wider social network. Discussion: Social isolation is multidimensional. The reciprocal relationship between social isolation from wider social networks and accumulating frailty deficits, and frailty as a clinical syndrome influencing social isolation from social networks is discussed.

Factors Influencing the Stages of Frailty among Korean Older Adults Focusing on Objective and Subjective Social Isolation

“…Social isolation was an in uential factor in the worsening transition between the stages of frailty. These results are similar to those of previous studies [21][22][23]34]. However, previous studies had limitations in that the multidimensionality of social isolation was not considered and the in uence on each step of transition between the stages of frailty could not be analyzed.…”

“…The social network of the elderly is mostly composed of family and long-term friends [26], and the number of people with whom important issues could be discussed continues to decrease [27]. Such an increase in social isolation among older adults is thus predicted to be an important risk factor of frailty [21][22][23]. However, only a few studies have investigated the correlation between the multidimensional properties of social isolation (subjective and objective social isolation) and the stages of frailty.…”

“…According to previous studies, personal factors such as sociodemographic characteristics (e.g., education level, age, gender, and household income) [12,[16][17][18], regular exercise [4,17], cognitive functions [19,20], functional levels, and sensory functions [18] have been identi ed as the risk factors of frailty. In addition, social factors such as social isolation were important factors progressing frailty [21][22][23]. Social isolation is multidemensional and can be divided into subjective social isolation and objective social isolation [24].…”

Relationships between non-communicable disease, social isolation and frailty in community dwelling adults in later life: findings from the Hertfordshire Cohort Study

“…We were interested to consider whether any possible association between the number of NCDs and social isolation could be explained by the presence of frailty after previous work in ELSA that found that social isolation predicted higher frailty levels, and higher frailty levels predicted greater social isolation [ 39 ]. In our study, adjustment for frailty did not remove associations between social isolation and NCDs in women, possibly because there were low numbers of individuals living with frailty in our population sample.…”

“…The occurrence of NCDs in older adults is often accompanied by frailty [ 34 , 35 ], a multi-dimensional geriatric syndrome that can be defined as a state of increased vulnerability resulting from decreased physiological reserves, multi-system dysregulation and limited capacity to maintain homeostasis [ 36 , 37 ]. Frailty is associated with higher risks of falls, disability, hospitalisation and mortality [ 38 ], and it has been reported to predict increased social isolation [ 39 ]. It is thus possible that any link between NCDS and social isolation might be mediated by frailty.…”