Social factors associated with reversing frailty progression in community-dwelling late-stage elderly people: An observational study

Abstract

Frailty is considered to be a complex concept based mainly on physical vulnerability, but also vulnerabilities in mental/psychological and social aspects. Frailty can be reversible with appropriate intervention; however, factors that are important in recovering from frailty have not been clarified. The aim of the present study was to identify factors that help an individual reverse frailty progression and characteristics of individuals that have recovered from frailty. Community-dwelling people aged ≥75 years who responded to the Kihon Checklist (KCL) were enrolled in the study. The KCL consists of 25 yes/no questions in 7 areas: daily-life related activities, motor functions, nutritional status, oral functions, homebound, cognitive functions, and depressed mood. The number of social activities, degree of trust in the community, degree of interaction with neighbors, and subjective age were also evaluated. Frailty was assessed based on the number of checked items: 0–3 for robust, 4–7 for pre-frailty, and ≥8 for frailty. A total of 5050 participants were included for statistical analysis. At the time of the baseline survey in 2016, 18.7% (n = 942) of respondents had frailty, and the follow-up survey showed that the recovery rate from frailty within 2 years (median 24 months) was 31.8% (n = 300). Multiple logistic regression analysis showed that exercise-based social participation (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.2–3.4; P<0.01) and self-rated health (OR 1.2, CI 1.0–1.5; P = 0.02) were related to reversing frailty progression. Principal component analysis indicated that the main factors constituting the first principal component (contribution rate, 18.3%) included items related to social capital, such as interaction with neighbors, trust in the community, and number of social participation activities. Our results demonstrate that exercise-based social participation and high self-rated health have associations with reversing frailty progression. Individuals that recovered from frailty are characterized by high individual-level social capital components (i.e., trust in community, interaction with neighbors, and social participation).

Effectiveness of the Questionnaire for Medical Checkup of Old‐Old (QMCOO) to diagnose frailty in community‐dwelling older adults

“…Because frailty could be reversible with appropriate intervention, 2 early diagnosis and intervention approaches are crucial. However, the diagnosis of frailty lacks definite criteria.…”

An Overview of Social Participation in Older Adults: Concepts and Assessments

“…In Japan, the relationship between social participation and each factor in older adults has been investigated. In addition, in previous studies, social participation was associated with better cognitive function [19][20][21][22][23] ; less depressive symptoms [24][25][26][27][28] and psychological distress 29 ) ; more instrumental activities of daily living [30][31][32] ; less functional disability [33][34][35][36][37][38] ; better physical activity [39][40][41] ; better life-space mobility 42 ) ; better mental health 43 ) ; self-related health 44 ) and health-related quality of life 45 ) ; social isolation 46,47 ) ; medical care costs 46,47 ) ; and a lower incidence of dementia 48) , frailty [49][50][51] , and mortality 52) in Japanese older adults (Fig. 1).…”

Long-term participation in community-based group resistance exercises delays the transition from robustness to frailty in older adults: a retrospective cohort study

“…Of the 42,775 community-dwelling older adults from 16 studies (mean follow-up duration: 3.9 years), the condition of 23.1% of individuals with pre-frailty improved to the robust state, compared to only 3.3% of those who were in the state of frailty at baseline [ 19 ]. A recent study found that participation in exercise-based social activities is associated with the reversal of frailty progression; however, the two-stage improvement from frailty to robustness was observed in only 5.8% of the population [ 20 ]. This suggests that it is important to maintain the prefrailty state for a long time and to prevent the deterioration of the frail state.…”