Abstract
Population aging is a challenge, therefore efficient frailty screening has been increasingly emphasized for mass older populations. This study aimed to evaluate the prevalence of social frailty and its association with physical frailty, geriatric syndromes and activity of daily living (ADL) disability in community-dwelling older adults. A cross-sectional study was conducted with 408 older adults (mean age, 75 years; 58% female) in the Aging Study of PyeongChang Rural Area. A five-item social frailty index was administered (range: 0–5); (1) going out less frequently; (2) rarely visiting the homes of friends; (3) feeling unhelpful to friends and family; (4) being alone; and (5) not talking with someone every day. Social frailty was defined as ≥2 positive responses. Physical frailty was assessed according to the Cardiovascular Health Study frailty phenotype criteria. We used logistic regression to examine whether social frailty can identify older adults with common geriatric syndromes including ADL disability, independently of age, gender, and physical frailty. Social frailty was present in 20.5% (14.5% in male and 25.0% in female) and 11.5% was not overlapped with physical frailty. Social frailty increased risk of ADL disability (odds ratio, 2.53; 95% confidence interval, 1.26–5.09) and depressed mood (odds ratio, 4.01; 95% confidence interval, 1.30–12.39) independently of age, gender, and physical frailty. The predictive power for disability was maximized by using both frailty indices (C statistic 0.73) compared with either frailty index alone (C statistic: 0.71 for social frailty and 0.68 for physical frailty). Social frailty screening is important as it can identify frail older adults who are not captured by demographic characteristics and physical frailty. Moreover, assessment of both social frailty and physical frailty can better detect disability and geriatric syndromes.
Highlights
Frailty in older adults is defined as a decreased physiological reserve associated with increased vulnerability to various stressors [1]
To evaluate the association of social frailty and physical frailty, the proportion of participants with social frailty and physical frailty was visualized with Venn diagram, and we examined the prevalence of common geriatric syndromes for those who had social frailty or physical frailty
Social frailty score correlated with most geriatric syndromes including multimorbidity, cognitive impairment, depressive mood, sarcopenia, dysmobility, fall, polypharmacy and malnutrition (Table S1)
Summary
Frailty in older adults is defined as a decreased physiological reserve associated with increased vulnerability to various stressors [1]. In Korea 10–16% are frail and 43–59% are prefrail in an urban population [2]. Older Koreans living in rural communities have a disproportionately greater burden of frailty and aging-related health conditions than those in urban communities. One study showed that 17.4% were frail and 52.6% were prefrail in a rural population [3]. Res. Public Health 2019, 16, 2809; doi:10.3390/ijerph16162809 www.mdpi.com/journal/ijerph
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