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Frailty and Social Isolation: Comparing the Relationship between Frailty and Unidimensional and Multifactorial Models of Social Isolation.

ABSTRACT: Objective: The aim of the study was to compare uni- and multidimensional models of social isolation to improve the specificity of determining associations between social isolation and frailty. Methods: The study included participants aged ≥60 years from the English Longitudinal Study of Ageing assessed for social isolation and frailty (frailty index and Fried phenotype) over a 4-year period. Factor analysis assessed whether social isolation was multidimensional. Multiple regression analysis was used to assess specificity in associations between social isolation and frailty over time. Results: Social isolation comprises social isolation from nuclear family, other immediate family, and wider social networks. Over time, social isolation from a wider social network predicted higher frailty index levels, and higher frailty index and Fried phenotype levels predicted greater social isolation from a wider social network. Discussion: Social isolation is multidimensional. The reciprocal relationship between social isolation from wider social networks and accumulating frailty deficits, and frailty as a clinical syndrome influencing social isolation from social networks is discussed.

SUBMITTER: Maltby J

PROVIDER: S-EPMC8689424 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Frailty and Social Isolation: Comparing the Relationship between Frailty and Unidimensional and Multifactorial Models of Social Isolation.

Maltby John J Hunt Sarah A SA Ohinata Asako A Palmer Emma E Conroy Simon S

Journal of aging and health 20200609 10

<b>Objective:</b> The aim of the study was to compare uni- and multidimensional models of social isolation to improve the specificity of determining associations between social isolation and frailty. <b>Methods:</b> The study included participants aged ≥60 years from the English Longitudinal Study of Ageing assessed for social isolation and frailty (frailty index and Fried phenotype) over a 4-year period. Factor analysis assessed whether social isolation was multidimensional. Multiple regression ...[more]

PMID: 32515634

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Project description:BACKGROUND:Many instruments to identify frail older people have been developed. One of the consequences is that the prevalence rates of frailty vary widely dependent on the instrument selected. The aims of this study were 1) to examine the concordances and differences between a unidimensional and multidimensional assessment of frailty, 2) to assess to what extent the characteristics of a 'frail sample' differ depending on the selected frailty measurement because 'being frail' is used in many studies as an inclusion criterion. METHOD:A cross-sectional study was conducted among 196 community-dwelling older adults (≥60 years), which were selected from the census records. Unidimensional frailty was operationalized according to the Fried Phenotype (FP) and multidimensional frailty was measured with the Comprehensive Frailty Assessment Instrument (CFAI). The concordances and differences were examined by prevalence, correlations, observed agreement and Kappa values. Differences between sample characteristics (e.g., age, physical activity, life satisfaction) were investigated with ANOVA and Kruskall-Wallis test. RESULTS:The mean age was 72.74 (SD 8.04) and 48.98% was male. According to the FP 23.59% was not-frail, 56.92% pre-frail and 19.49% frail. According to the CFAI, 44.33% was no-to-low frail, 37.63% was mild frail and 18.04% was high frail. The correlation between FP and the CFAI was r = 0.46 and the observed agreement was 52.85%. The Kappa value was κ = 0.35 (quadratic κ = 0.45). In total, 11.92% of the participants were frail according to both measurements, 7.77% was solely frail according to the FP and 6.21% was solely frail according to the CFAI. The 'frail sample respondents' according to the FP had higher levels of life satisfaction and net income, but performed less physical activities in comparison to high frail people according to the CFAI. CONCLUSION:The present study shows that the FP and CFAI partly measure the same 'frailty-construct', although differences were found for instance in the prevalence of frailty and the composition of the 'frail participants'. Since 'being frail' is an inclusion criterion in many studies, researchers must be aware that the choice of the frailty measurement has an impact on both the estimates of frailty prevalence and the characteristics of the selected sample.

Project description:BackgroundThe Institut Pasteur de Lille, in the north of France, has implemented a large, multidisciplinary health check, which aims to identify frailty in middle-aged caregivers. We aimed to construct an adapted frailty index of cumulative deficit (FI-CD) and study the associated factors, in particular socioeconomic factors.MethodsThe cross-sectional study included caregivers aged 45 to 65. A 34-item FI-CD including deficits adapted to a middle-aged population (related to cognition and autonomy, dietetics, physical activity, comorbidities, functional signs, lab values and paraclinical examinations) was constructed in accordance with standard procedures. It was calculated as a ratio of deficits present out of the total number of possible deficits, giving a continuous score between 0 and 1. Scores > 0.25 and > 0.4 were classified as frailty and severe frailty, respectively. Univariate and multivariate associations were studied using linear regressions.ResultsOne hundred and seventeen caregivers were included; among them, 111 were analyzed due to missing values. The mean FI-CD was 0.22 ± 0.08. Forty (36%) individuals were classified as frailty and three (2.7%) as severe frailty. In multivariate analysis, FI-CD was significantly associated with age (beta [95% confidence interval] = 0.005 [0.002; 0.009] per 1-year increase, p = 0.005) and social deprivation (beta = 0.054 [0.007; 0.102], p = 0.025). A significant interaction was observed between and age and social deprivation (p = 0.036). The adjusted relationship between FI-CD and age was beta = 0.010 [0.002; 0.019], p = 0.017 in precarious caregivers, and beta = 0.003 [- 0.001; 0.007], p = 0.19 in non-precarious caregivers.ConclusionsThe study suggested that the 34-item FI-CD could have clinical utility in the management of middle-aged caregivers. Social deprivation appeared as an important factor associated with frailty, highlighting the importance of early care and social support for precarious caregivers.

Dataset Information

Frailty and Social Isolation: Comparing the Relationship between Frailty and Unidimensional and Multifactorial Models of Social Isolation.

Publications

Frailty and Social Isolation: Comparing the Relationship between Frailty and Unidimensional and Multifactorial Models of Social Isolation.

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