Frailty as a Moderator of the Relationship between Social Isolation and Health Outcomes in Community-Dwelling Older Adults.

Fereshteh Mehrabi,François Béland

doi:10.3390/ijerph18041675

Abstract

This research investigated the effects of social isolation on frailty and health outcomes and tested whether these associations varied across different levels of frailty. We performed a multivariate analysis of the first wave of Frailty: A longitudinal study of its expressions (FRéLE) among 1643 Canadian older adults aged 65 years and over. We assessed social isolation using social participation, social networks, and support from various social ties, namely, friends, children, extended family, and partner. Frailty was associated with disability, comorbidity, depression, and cognitive decline. Less social participation was associated with limitations in instrumental activities of daily living (IADLs), depression, and cognitive decline. The absence of friends was associated with depression and cognitive impairment. Less social support from children and partner was related to comorbidity, depression, and cognitive decline. Overall, social isolation is linked to mental health rather than physical health. The associations of having no siblings, receiving less support from friends, and participating less in social activities with ADL limitations, depression, and cognitive decline were higher among frail than prefrail and robust older adults. This study corroborates the pivotal role of social connectedness, particularly the quality of relationships, on the mental health of older adults. Public health policies on social relationships are paramount to ameliorate the health status of frail older adults.

Highlights

The effect of social isolation on health among older people has recently garnered increasing attention from the media and policymakers alike, recognizing it as an emerging public health priority [1,2]
We examined our first hypothesis by testing the effects of social isolation on frailty and on adverse health outcomes, including disability, chronic diseases, depression, and cognitive decline
We investigated our second hypothesis via examination of the interaction effects of social isolation and frailty on health outcomes

Summary

Introduction

The effect of social isolation on health among older people has recently garnered increasing attention from the media and policymakers alike, recognizing it as an emerging public health priority [1,2]. Roughly 50% of older people are at risk of social isolation, and about one-third of those aged 60 years and over experience loneliness in later life [3]. Social isolation is a known risk factor for a wide array of adverse health outcomes among older people, including disability [5], cognitive decline [6,7], depression [8], and mortality [9]. HoltLunstad and colleagues [10] posited that the influence of social isolation on health is comparable with that of well-established risk factors, including smoking and obesity.

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Discussion

Conclusion