Loneliness as a risk factor for frailty transition among older Chinese people

Abstract

Background: Previous literature has reported that loneliness is a strong predictor of frailty risk. However, less is known about the role of loneliness in frailty transition types. This study aimed to examine whether and how loneliness are related to frailty transition among older Chinese people. Methods: Our study used participants (aged ≥60 years) from 2008/2009, 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Loneliness was assessed by a single question asking how often the respondent feels lonely. The FRAIL Scale was created to measure physical frailty for our study, and frailty was also assessed by a broader definition of the frailty index. Frailty transition as an outcome variable has been designed as two types according to the measurement of frailty. Results: Greater loneliness at baseline reduced the possibility of remaining in a robust or prefrail physical frailty state after 3 years (OR = 0.78, 95%CI: 0.68-0.91, p < 0.01). Greater loneliness was associated with an increased risk of worsening physical frailty over time: compared with those who had never felt lonely, the odds ratios for people who often felt lonely were 1.19 (95%CI: 1.01-1.41, p < 0.05) after 3 years and 1.34 (95%CI: 1.08-1.66, p < 0.01) after 6 years. The association between loneliness and change in the frailty index differed in the survey periods: loneliness at baseline was found to increase the possibility of participants remaining in frailty (seldom loneliness: OR = 1.78, 95%CI: 1.25-2.55, p < 0.01; often loneliness: OR = 1.74, 95%CI: 1.21-2.50, p < 0.01) after 6 years, but no significance was shown in the 3-year follow up. Additionally, loneliness at baselines was significantly associated with frailty transition at follow up among the male participants. However, a similar association was not observed among the female participants. Conclusion: Older people with a high level of loneliness tend to be frail in the future, and greater loneliness is related to an increased risk of worsening frailty and remaining frail. Male elderly with a high level of loneliness were more likely to have a worse frailty transition than female elderly in China.

What Is Frailty? Perspectives from Chinese Clinicians and Older Immigrants in New Zealand

“…The association of social factors (e.g. unfavourable socioeconomic status, living alone, unmarried, loneliness, reduced social participation) and frailty was confirmed in previous Chinese studies (Sha et al 2020;Wu et al, 2018;Ye et al, 2018;Ye et al 2020). An indeed, Malmstrom and Morley (2013) developed a scale "SOCIAL" to screen for psychosocial risk factors for frailty: Sadness, Outside activity, Cognition, Income adequacy, Attachment to neighbour, Lethargy.…”

Trajectories of physical frailty and cognitive impairment in older adults in United States nursing homes

“…The experience of older residents while living in the nursing home may influence the trajectory of physical frailty. In addition to nursing home admission [ 41 , 42 ], social isolation and loneliness are notable risk factors for physical frailty [ 43 , 44 ] in older adults. The improving trajectory may reflect some older adults’ experience of adjusting to communal living, becoming more engaged in social activities, and having the support from other residents and staff.…”

Long-term tea consumption reduces the risk of frailty in older Chinese people: Result from a 6-year longitudinal study

“…For each participant, the FI scores were measured as the sum of deficit scores divided by the amount of deficit included, ranging from 0 to 1. The participants with a score of >0.21 were referred to as frail ( 32 ), while those with a score of <0.21 were referred to as not frail. Detailed deficits of the frailty index are shown in Supplementary Table 1 .…”