Abstract
BackgroundThere is a shortage of research evidence about how social isolation, social participation, and loneliness were longitudinally associated with frailty. This study was to 1) examine the associations of social isolation, social participation, and loneliness with level of frailty among community-dwelling older adults using panel data, and 2) explore the moderating effect of gender on the association of social isolation, social participation and loneliness with frailty.MethodsThe study included 606 participants aged 60 years and above from the longitudinal Population Health Index Survey conducted in Singapore. At each timepoint, level of frailty was determined using the Clinical Frailty Scale. Social isolation was assessed by the Lubben Social Network Scale-6, and loneliness was assessed using the three-item UCLA Loneliness Scale. Fixed-effects ordinal logistic regressions were conducted with level of frailty as the dependent variable and social isolation and loneliness as the independent variables, adjusting for time-varying socio-demographic, lifestyle, and health-related factors.ResultsIncrease in social participation was associated with lower level of frailty (odds ratio: 0.96, 95% confidence interval: 0.93–0.99) and feeling lonely was associated with higher level of frailty (odds ratio: 2.90, 95% confidence interval: 1.44–5.84). Social isolation was not associated with frailty. Gender did not have moderating effect on these associations.ConclusionsThis study observed that social isolation and loneliness had differential longitudinal association with level of frailty among community-dwelling older adults and suggested that loneliness and frailty should be measured and addressed concurrently among community-dwelling older adults.
Highlights
There is a shortage of research evidence about how social isolation, social participation, and loneliness were longitudinally associated with frailty
Written informed consent was obtained from all individual participants after they were being informed about the study objectives and the safeguards put in place so that confidentiality of the collected data is maintained
Similar to the findings from existing evidence [24,25,26, 45], our study showed that feeling lonely was consistently associated with higher odds of worsened frailty and their association was independent of social isolation and social participation
Summary
There is a shortage of research evidence about how social isolation, social participation, and loneliness were longitudinally associated with frailty. In Singapore, population ageing, change in family structure, and shift towards nuclear families increase the likelihood of social isolation [8] and loneliness. Despite no consensus definition of frailty or operational criteria for frailty assessment, prior research has consistently shown that frail older adults are at increased risk of falls and disability [14, 15], hospitalisation [16, 17], and mortality [18, 19]. To forge a frailty-ready community to meet the challenges of population ageing, a better understanding of the risk factors of frailty and identifying effective approaches to attenuate the development and progression or even reversion of frailty is essential
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