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Social frailty domains may play an important role in preventing physical decline and disability. The aim of this study is to examine the impact of social frailty as a risk factor for the future development of physical frailty among community-dwelling older adults who are not yet physically frail. A total of 1226 physically non-frail older adults were analyzed to provide a baseline. Participants completed a longitudinal assessment of their physical frailty 48 months later. Their baseline social frailty was determined based on their responses to five questions, which identified participants who went out less frequently, rarely visited friends, felt less like helping friends or family, lived alone and did not talk to another person every day. Participants with none of these characteristics were considered not to be socially frail; those with one characteristic were considered socially pre-frail; and those with two or more characteristics were considered socially frail. At the four-year follow-up assessment, 24 participants (2.0%) had developed physical frailty and 440 (35.9%) had developed physical pre-frailty. The rates of developing physical frailty and pre-frailty were 1.6% and 34.2%, respectively, in the socially non-frail group; 2.4% and 38.8%, respectively, in the socially pre-frail group; and 6.8% and 54.5%, respectively, in the socially frail group. Participants classified as socially frail at the baseline had an increased risk of developing physical frailty, compared with participants who were not socially frail (OR = 3.93, 95% CI = 1.02–15.15). Participants who were socially frail at the baseline also had an increased risk of developing physical pre-frailty (OR = 2.50, 95% CI = 1.30–4.80). Among independent community-dwelling older adults who are not physically frail, those who are socially frail may be at greater risk of developing physical frailty in the near future. Social frailty may precede (and lead to the development of) physical frailty.

Background: The aim of this study was to examine the association of the multiple facets of oral, motor, and social functions in community-dwelling older adults, to identify factors that might influence the risk of frailty. Methods: Of the 82 participants included in the study, 39 (5 males and 34 females) were young-old adults, with an average age of 70.5 ± 2.8 years, and 43 (14 males and 29 females) were old-old adults, with an average age of 78.7 ± 2.9 years. We assessed the risk factors for frailty among oral, motor, and social functions. Results: Statistical analysis showed a significant difference in the oral diadochokinesis between the groups (p = 0.006). According to the Spearman correlation analysis, a significant association was observed with age and oral diadochokinesis (rs = −0.262, p = 0.018), and social support (rs = −0.219, p = 0.049). Moreover, binomial logistic regression analysis revealed a significant association of frailty with the occlusal force (odds ratio, 0.031; 95% confidence interval (95% CI), 0.002–0.430; p = 0.010), General Oral Health Index (odds ratio, 0.930; 95% CI, 0.867–0.999, p = 0.046), and availability of social support (odds ratio, 0.803, 95% CI, 0.690–0.934, p = 0.004). Conclusions: To prevent frailty at an early stage, assessments of oral functions, and also that of the availability of social support, are important.

Social frailty is a rather unexplored concept. In this paper, the concept of social frailty among older people is explored utilizing a scoping review. In the first stage, 42 studies related to social frailty of older people were compiled from scientific databases and analyzed. In the second stage, the findings of this literature were structured using the social needs concept of Social Production Function theory. As a result, it was concluded that social frailty can be defined as a continuum of being at risk of losing, or having lost, resources that are important for fulfilling one or more basic social needs during the life span. Moreover, the results of this scoping review indicate that not only the (threat of) absence of social resources to fulfill basic social needs should be a component of the concept of social frailty, but also the (threat of) absence of social behaviors and social activities, as well as (threat of) the absence of self-management abilities. This conception of social frailty provides opportunities for future research, and guidelines for practice and policy.

BackgroundOsteosarcopenia is a newly described, aging-associated condition. Social frailty is an important condition whose prevalence may have risen by physical distancing during the coronavirus disease 2019 pandemic. However, the relationship between these two remains unclear.AimsTo examine the association between osteosarcopenia and social frailty.MethodsThis cross-sectional study was conducted using data from outpatients visiting general geriatric hospital frailty clinics. Bone mineral density (BMD) and muscle mass were measured using dual X-ray absorptiometry. Osteoporosis was defined as a BMD of < 70% of the young adult mean, according to the Japan Osteoporosis Society. Sarcopenia was diagnosed as per the Asian Working Group for Sarcopenia 2019 recommendation. Osteosarcopenia was defined as the co-existence of osteoporosis and sarcopenia. We defined social frailty using a questionnaire comprising four items: general resources, social resources, social behavior, and basic social needs. Ordinal logistic regression analysis was performed with social frailty status and osteosarcopenia as the dependent and independent variables, respectively.ResultsWe included 495 patients (mean age = 76.5 ± 7.2 years) in the analysis; of these, 58.2% were robust and 17.2%, 13.5%, and 11.1% had osteoporosis alone, sarcopenia alone, and osteosarcopenia, respectively. Social frailty prevalence increased stepwise from 8.0% in robust patients to 11.8%, 17.9%, and 29.1% among those with osteoporosis alone, sarcopenia alone, and osteosarcopenia, respectively (P < 0.001). Logistic regression analysis revealed that only osteosarcopenia was significantly associated with social frailty (pooled odds ratio: 2.117; 95% confidence interval: 1.104–4.213).DiscussionComprehensive assessment of osteosarcopenia and social frailty is needed for disability prevention in older adults.

Background It has not been clarified whether physical frailty symptoms predict social. frailty. The purpose of this study was to elucidate the effect of physical frailty on social frailty, and to determine which domains of physical frailty predict the development of social frailty. Methods We employed a two-year prospective cohort study. A total of 342 socially robust community-dwelling older adults were recruited. We used a modified social frailty screening index consisting of four social domains including financial difficulties, living alone, social activity, and contact with neighbors. Physical frailty status was also assessed at baseline. At the two-year follow-up, we assessed the development of social frailty. Social status was assessed using four social subdomains for the primary analysis. Social status was assessed using the two social subdomains of social activity and contact with neighbors, which would be affected by the physical frailty component, for the secondary analysis. The risk ratios (RR) of physical frailty for the development of social frailty were estimated. Results Although physical frailty symptoms were not a significant risk factor for future development of social frailty as assessed by four social subdomains (adjusted RR 1.39, 95% CI 0.95–2.15), it became significant when development of social frailty was assessed by the two social subdomains (adjusted RR 1.78, 95% CI 1.10–2.88). An analysis using the physical frailty subdomain showed that slow gait speed (adjusted RR 3.41, 95% CI 1.10–10.53) and weakness (adjusted RR 1.06, 95% CI 1.01–1.12) were independent risk factors for development of social frailty as assessed by two social subdomains. Conclusions Physical frailty symptoms predict the development of social frailty. Among physical frailty subdomains, gait speed and muscle strength are critical independent risk factors for future decline in the social aspect. The prevention of physical frailty, especially by maintaining gait ability and muscle strength, may be effective for avoiding social frailty.

Background With the aging of the population, frailty has attracted much attention, and the social dimension of frailty, namely social frailty, has also attracted attention. Studies have shown that social frailty can bring some adverse effects to the elderly, such as physical and cognitive function. Aims To explore the risk of adverse health outcomes in older adults with social frailty compared with older adults with non-social frailty. Methods Five databases were systematically searched from inception to February 28, 2023. Screening, data extraction and quality assessment were conducted independently by two researchers. The included studies were longitudinal studies of adverse outcomes in community-dwelling socially frail older adults, and the quality of each study was assessed using the Newcastle‒Ottawa Scale. Results A total of 15 studies were included based on the inclusion criteria, of which 4 were subjected to meta-analysis. The mean age of the included population ranged from 66.3 to 86.5 years. According to existing research, social frailty was predictive of some adverse outcomes, such as incident disability, depressive symptoms, and reduced neuropsychological function. The meta-analysis showed that social frailty had a significant predictive effect on mortality among older adults [HR = 2.27, (95% CI = 1.03–5.00)]. Conclusion In community-dwelling older adults, social frailty was a predictor of mortality, incident disability, depressive symptoms and other adverse outcomes. Social frailty had a negative impact on older adults, so it was necessary to strengthen the screening of social frailty to reduce the incidence of adverse outcomes.

Social frailty is related to adverse health-related outcomes. However, the measurement thereof is controversial and research into the relationship between social frailty and physical functioning remains limited. This study aimed to determine social frailty status via developing a simple self-reported screening tool, termed the HALFT scale, and to examine the association between social frailty and physical functioning, cognition, depression, and mortality among community-dwelling older adults. Prospective cohort study. Community. 1697 community-dwelling adults aged ≥60 years from Beijing Longitudinal Study of Aging were included. The HALFT scale was developed based on 5 items: unhelpful to others, limited social participation, loneliness, financial difficulty, and not having anyone to talk to. Socioeconomic and demographic data were collected, and physical functioning, frailty index, cognition, and depression were assessed. The prevalence of social frailty was 7.7% (weighted, 4.5%). Participants with physical frailty, low levels of physical activity, and poor physical functioning had a higher prevalence of social frailty. Social frailty was associated with dementia, subjective memory decline, depression, cognitive impairment, and having experienced a recent significant life event. After adjusting for age and sex, the 8-year mortality hazard ratios were 2.5-4.3 and 1.6-2.3, respectively, for those with social frailty or pre-social frailty. Each component of the HALFT scale predicted 8-year mortality. Social frailty is associated with physical functioning, cognition, and depression, and predicts mortality. The HALFT scale could be a useful screening tool for determining social frailty in older adults. Interventions aimed at preventing or delaying social frailty are warranted.

Notwithstanding the increasing body of evidence that links social determinants to health outcomes, social frailty is arguably the least explored among the various dimensions of frailty. Using available items from previous studies to derive a social frailty scale as guided by the Bunt social frailty theoretical framework, we aimed to examine the association of social frailty, independently of physical frailty, with salient outcomes of mood, nutrition, physical performance, physical activity, and life–space mobility. We studied 229 community-dwelling older adults (mean age 67.22 years; 72.6% females) who were non-frail (defined by the FRAIL criteria). Using exploratory factor analysis, the resultant 8-item Social Frailty Scale (SFS-8) yielded a three-factor structure comprising social resources, social activities and financial resource, and social need fulfilment (score range: 0–8 points). Social non-frailty (SNF), social pre-frailty (SPF), and social frailty (SF) were defined based on optimal cutoffs, with corresponding prevalence of 63.8%, 28.8%, and 7.4%, respectively. In logistic regression adjusted for significant covariates and physical frailty (Modified Fried criteria), there is an association of SPF with poor physical performance and low physical activity (odds ratio, OR range: 3.10 to 6.22), and SF with depressive symptoms, malnutrition risk, poor physical performance, and low physical activity (OR range: 3.58 to 13.97) compared to SNF. There was no significant association of SPF or SF with life–space mobility. In summary, through a theory-guided approach, our study demonstrates the independent association of social frailty with a comprehensive range of intermediary health outcomes in more robust older adults. A holistic preventative approach to frailty should include upstream interventions that target social frailty to address social gradient and inequalities.

Frailty is a dynamic condition encompassing physical, psychological, and social domains. While certain factors are associated with overall or specific frailty domains, research on the correlations between physical, psychological, and social frailty is lacking. This study aims to investigate the associations between physical, psychological, and social frailty in European older adults. The study involved 1781 older adults from the Urban Health Centres Europe project. Baseline and 1-year follow-up data were collected on physical, psychological, and social frailty, along with covariates. Linear regression analyzed unidirectional associations, while cross-lagged panel modeling assessed bi-directional associations. Participants’ mean age was 79.57 years (SD = 5.54) and over half were female (61.0%). Physical and psychological frailty showed bi-directional association (effect of physical frailty at baseline on psychological frailty at follow-up: β  = 0.14, 95%CI 0.09, 0.19; reversed direction: β  = 0.05, 95%CI 0.01, 0.09). Higher physical frailty correlated with increased social frailty ( β  = 0.05, 95%CI 0.01, 0.68), but no association was found between social and psychological frailty. This longitudinal study found a reciprocal relationship between physical and psychological frailty in older adults. A relatively higher level of physical frailty was associated with a higher level of social frailty. There was no association between social and psychological frailty. These findings underscore the multifaceted interplay between various domains of frailty. Public health professionals should recognize the implications of these interconnections while crafting personalized prevention and care strategies. Further research is needed to confirm these findings and investigate underlying mechanisms.

Background Dynapenia and frailty are known to be strong predictors of decreased function and increased mortality in the older adults. However, limited research on the co-occurrence of these factors and the different frailty domains makes their relationship with fall risk poorly understood. The aim of this study was to investigate the relationship between fall risk, dynapenia phenotypes, and frailty domains in the older adults. Methods In this cross-sectional study of 400 outpatients aged 65+, without major functional, cognitive, or serious comorbid issues, fall risk was assessed using the Berg Balance Scale. Frailty was evaluated via the TFI across physical, psychological, and social domains. Handgrip dynamometry determined dynapenia, classifying the participants into robust, dynapenic, abdominally obese, and dynapenic-obese phenotypes. To examine the associations between frailty, dynapenia, and fall risk, we applied a comprehensive, multi-layered analytical strategy covering all plausible combinations. Associations were analyzed using univariate and multivariate regressions in SPSS v23. Results In univariate analyses, fall risk was markedly higher among older adults with dynapenia (59.2%) or multidimensional frailty (60%), and peaked when both conditions coexisted (67.9%). Multivariate models demonstrated that dynapenia (OR = 2.75; 95% CI: 1.48–5.12) and frailty (OR = 2.56; 95% CI: 1.39–4.70) were independently associated with increased fall risk, with a pronounced effect when both were present (OR = 20.45; 95% CI: 6.02–46.69). Among frailty components, only physical (OR = 1.39; 95% CI: 1.19–1.62) and social frailty (OR = 1.38; 95% CI: 1.03–1.84) remained significant predictors in adjusted analyses. Interaction effects revealed that combining dynapenia with these domains further heightened the risk. A clear dose-response pattern emerged: fall risk escalated from 3.24-fold (95% CI: 1.48–3.09) with two frailty domains plus dynapenia, to 7.27-fold (95% CI: 3.46–7.29) when all three domains co-occurred. Conclusion Dynapenia and frailty, particularly in physical and social domains, independently and jointly elevate fall risk in older adults. Their co-occurrence demonstrates a dose-dependent effect, underscoring the need for integrated assessments to better identify and manage those at highest risk.