Abstract
Objective
To determine the prevalence of social frailty and its relation to incident disability
and mortality in community-dwelling Japanese older adults.
Design
Prospective cohort study.
Setting and Participants
6603 community-dwelling adults aged 65 years and older who were living independently
in a city in Shiga prefecture in 2011.
Outcomes
The outcomes were incident disability and mortality. We defined incident disability
using new long-term care insurance (LTCI) service requirement certifications, and
the follow-up period was 6 years after the mailed survey.
Measurements
The 4-item social frailty screening questionnaire was developed and included general
resources, social resources, social behavior, and fulfillment of basic social needs.
We categorized the respondents into 3 groups based on the level of social frailty.
Additionally, we assessed physical/psychological frailty by the frailty screening
index and other demographic variables.
Results
The prevalences of social frailty, social prefrailty, and social robust were 18.0%,
32.1%, and 50.0%, respectively. During the 6-year follow-up period, 28.1% of those
with social robust, 36.9% of those with social prefrailty, and 48.5% of those with
social frailty died or experienced incident disability. Those with social prefrailty
[adjusted hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.16-1.41] and social
frailty (adjusted HR 1.71, 95% CI 1.54-1.90) had significantly elevated risks for
incident disability and mortality based on multivariate analyses that used social
robust as the reference. Furthermore, the combination of social frailty and physical/psychological
frailty is more likely to result in incident disability and mortality compared to
social frailty or physical/psychological frailty alone.
Conclusions/Implications
Community-dwelling older adults with both social frailty and physical/psychological
frailty are at higher risk of death or disability over 6 years than are older adults
with only one type of frailty or no frailty. Screening and preventive measures for
social frailty are suggested for healthy aging.
Keywords
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Article info
Footnotes
This work was supported by the Research Fund for Longevity Science (28-30) from the National Center for Geriatrics and Gerontology (NCGG), and Grants-in-Aid for Comprehensive Research on Aging and Health from the Ministry of Health, Labour, and Welfare, Japan.
The authors declare no conflicts of interest.
Identification
Copyright
© 2018 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
