Social Frailty Among Community-Dwelling Older Adults: Recommended Assessments and Implications

Abstract

Even though social factors that determine frailty in older people contribute to adverse health outcomes, there is little consensus in terms of the definition of social frailty. Therefore, in this article we reviewed literature on social frailty and attempted to define the term. Although we found that living alone, social participation, economic hardship, and other such factors are associated with a decline in activities of daily living and increased risk of disability, we have not reached an agreement on either the most effective methods of assessing social frailty or the most effective interventional approaches to address social frailty. Further investigations are needed to define social frailty and identify effective interventions to promote active aging by focusing on the social aspects in older adults with social frailty. It would be reasonable to think that this approach will also improve physical and cognitive frailty.

Keywords: Activities of Daily Living; Aging; Frailty; Health.

Fig. 1.

Prevalence of social frailty in National Center for Geriatrics and Gerontology-Study of Geriatric Syndrome. Adapted from Tsutsumimoto et al. J Am Med Dir Assoc 2017;18:603-7.21)

Fig. 2.

Associations of social frailty with cognitive and physical deficits. ^a)Declines in each domain: memory, attention, executive function, and processing speed. ^b)Slowness (<1.0 m/sec) or/and weakness (grip strength, <26 kg in men, <18 kg in women). Covariates: age, sex, education, hypertension, diabetes, hyperlipidemia, medications, working status, physical activity, depressive symptoms. *p<0.05. **p<0.01. Adapted from Makizako et al. J Am Med Dir Assoc 2015;16:1003.e7-11.4)

Fig. 3.

Social frailty and the risk of incidence of need for support or care. Adapted from Makizako et al. J Am Med Dir Assoc 2015;16:1003.e7-11.4)