Partner loss and its effect on frailty trajectories: results from the 13-year follow-up Survey of Health, Ageing and Retirement in Europe (SHARE)

Abstract

BackgroundFrailty is a geriatric syndrome closely linked to a variety of adverse health outcomes. Thus, it is important to identify factors associated with the development of frailty. It was the aim of this study to examine, if, and to what extent partner loss, a highly stressful life event, affects frailty trajectories of community dwelling adults aged 50 or older.MethodsUsing six waves of panel data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we investigated the effect of partner loss on frailty trajectories estimating growth curve models. Our sample included 183 502 observations of 83 494 community-dwelling individuals aged 50 or older from 21 European countries collected between 2004 and 2017. Frailty was measured using the validated sex-specific SHARE-Frailty-Instrument including muscular weakness, unintended weight loss, decrease in walking capacity, low physical activity and exhaustion.ResultsOur sample contained 79 874 participants who lived in a partnership during their entire observational period and 3620 participants who lost their partner during their observational period. Both men (β=0.184 (95% CI: −0.017 to 0.386), p=0.073) and women (β=0.237 (95% CI: 0.106 to 0.369), p<0.001) showed initial effects of partner loss on frailty, but while only women gradually recovered over time (β=−0.023 (95% CI: −0.039 to −0.008), p=0.002), among men, the effect of partner loss persisted (β<0.001 (95% CI: −0.029 to 0.029), p=0.998).ConclusionThis study revealed that partner loss is followed by elevated frailty. However, while women’s frailty tended to recover from partner loss over time, men’s frailty remained elevated. Notable individual differences in the response of frailty trajectories to partner loss suggest the existence of effect modifiers.

Heterogeneous Association of Tooth Loss with Functional Limitations

“…This indicates that dental care may help alleviate the impact of tooth loss on functional capacity decline, which is also supported by the results of the present study, in line with the results that the low-impact subgroup on intellectual activity was more likely to use dental prosthesis (Appendix Table 4). Having a partner provides social support, and losing a partner can accelerate frailty among older people (Oberndorfer et al 2022). The present study identified these potential effect modifiers that can independently or cumulatively increase the effect of tooth loss.…”

A Narrative Review of the Utilisation of the SHARE Frailty Instruments (SHARE-FI and SHARE-FI75+) in the Literature

“…A study in SHARE showed that loneliness and social isolation were associated with the risk of developing frailty or pre-frailty status, with relative risk ratio of 1.14 and 1.68, respectively, with the presence of loneliness; and 1.17 and 1.84, respectively, with social isolation 22 . Another study analysed the six waves of the SHARE study and extracted data from 79874 participants in partnerships and 3620 participants who lost their partners, finding that while men and women experienced an initial drop in frailty after the loss, women were more likely to recover the lost frailty points overtime while the effects on frailty persisted in men 23 . Also using SHARE, Ilinca and Calciolari showed that frailty was associated with greater utilisation of primary healthcare and hospital services 24 .…”