Relationships between non-communicable disease, social isolation and frailty in community dwelling adults in later life: findings from the Hertfordshire Cohort Study

Abstract

Background: social relationships play a fundamental role in individuals’ lives and health, and social isolation is prevalent among older people. Chronic non-communicable diseases (NCDs) and frailty are also common in older adults.

Aims: to examine the association between number of NCDs and social isolation in a cohort of community-dwelling older adults in the UK, and to consider whether any potential association is mediated by frailty.

Methods: NCDs were self-reported by 176 older community-dwelling UK adults via questionnaire. Social isolation was assessed using the six-item Lubben Social Network Scale. Frailty was assessed by the Fried phenotype of physical frailty.

Results: the median (IQR) age of participants in this study was 83.1 (81.5-85.5) years for men and 83.8 (81.5-85.9) years for women. The proportion of socially isolated individuals was 19% in men and 20% in women. More women (18%) than men (13%) were identified as frail. The number of NCDs was associated with higher odds of being isolated in women (unadjusted odds ratio per additional NCD: 1.65, 95% CI 1.08, 2.52, p=0.021), but not in men, and the association remained robust to adjustment, even when accounting for frailty (OR 1.85, 95% CI 1.06, 3.22, p=0.031).

Discussion: number of self-reported NCDs was associated with higher odds of social isolation in women but not in men, and the association remained after considering frailty status.

Conclusions: our observations may be considered by healthcare professionals caring for community-dwelling older adults with multiple NCDs, where enquiring about social isolation as part of a comprehensive assessment may be important.

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Identifiers

ORCID for Gregorio Bevilacqua: orcid.org/0000-0001-7819-1482

ORCID for Ilse Bloom: orcid.org/0000-0002-4893-1790

ORCID for Nicholas Fuggle: orcid.org/0000-0001-5463-2255

ORCID for Harnish Patel: orcid.org/0000-0002-0081-1802

ORCID for Kate Ward: orcid.org/0000-0001-7034-6750

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

ORCID for Elaine Dennison: orcid.org/0000-0002-3048-4961

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