Social isolation and loneliness as risk factors for the progression of frailty

Abstract

Background: loneliness and social isolation have been associated with mortality and with functional decline in older people. We investigated whether loneliness or social isolation are associated with progression of frailty.

Methods: participants were 2817 people aged ≥60 from the English Longitudinal Study of Ageing. Loneliness was assessed at Wave 2 using the Revised UCLA scale (short version). A social isolation score at Wave 2 was derived from data on living alone, frequency of contact with friends, family and children, and participation in social organizations. Frailty was assessed by the Fried phenotype of physical frailty at Waves 2 and 4, and by a frailty index at Waves 2-5.

Results: high levels of loneliness were associated with an increased risk of becoming physically frail or pre-frail around 4 years later: relative risk ratios (95% CI), adjusted for age, sex, level of frailty and other potential confounding factors at baseline were 1.74 (1.29, 2.34) for pre-frailty, and 1.85 (1.14, 2.99) for frailty. High levels of loneliness were not associated with change in the frailty index—a broadly-based measure of general condition--over a mean period of 6 years. In the sample as a whole, there was no association between social isolation and risk of becoming physically frail or pre-frail, but high social isolation was associated with increased risk of becoming physically frail in men. Social isolation was not associated with change in the frailty index.

Conclusions: older people who experience high levels of loneliness are at increased risk of becoming physically frail.

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Identifiers

ORCID for Catharine Gale: orcid.org/0000-0002-3361-8638

ORCID for Leo Westbury: orcid.org/0009-0008-5853-8096

ORCID for Cyrus Cooper: orcid.org/0000-0003-3510-0709

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