Associations of social engagement, and loneliness with the progression and reversal of frailty: longitudinal investigations of two prospective cohorts from the UK and the USA

Ziyi Cai; Anna Olia Papacosta; Lucy T Lennon; Peter H Whincup; Sasiwarang Goya Wannamethee; Eleanor M Simonsick; John C Mathers; Sheena E Ramsay

doi:10.1093/aje/kwae221

Associations of social engagement, and loneliness with the progression and reversal of frailty: longitudinal investigations of two prospective cohorts from the UK and the USA

Am J Epidemiol. 2024 Jul 25:kwae221. doi: 10.1093/aje/kwae221. Online ahead of print.

Authors

Ziyi Cai¹, Anna Olia Papacosta², Lucy T Lennon², Peter H Whincup³, Sasiwarang Goya Wannamethee², Eleanor M Simonsick⁴, John C Mathers¹, Sheena E Ramsay¹

Affiliations

¹ Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
² Department of Primary Care and Population Health, UCL, London, UK.
³ Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, UK.
⁴ National Institute on Aging Intramural Research Program, NIH, Baltimore, MD, USA.

PMID: 39060173
DOI: 10.1093/aje/kwae221

Abstract

Background: Social connections may impact the dynamic trajectory of frailty.

Methods: Using data from the British Regional Heart Study (BRHS) in the UK (n = 715), and the US Health, Aging and Body Composition (Health ABC) Study (n = 1256), we conducted multinominal regression analyses to examine the association of baseline and change in social engagement and loneliness with progression to pre-frailty and frailty, as well as their association with reversal to pre-frailty and robust status among older adults.

Results: A higher level of social engagement at baseline (BRHS: relative risk ratio (RRR) 0.69 [95%CI 0.55-0.85]; Health ABC: 0.56 [0.45-0.70]), as well as increase in social engagement (BRHS: 0.73, [0.59-0.90]; Health ABC: 0.51 [0.41-0.63]), were associated with a lower risk of developing frailty. In BRHS, a higher level of loneliness at baseline (1.42 [1.10-1.83]) and an increase in loneliness (1.50 [1.18-1.90]), increased the risk of developing frailty. For reversal of frailty, higher social engagement at baseline (Health ABC: 1.63 [1.08-2.47]) and an increase in social engagement (BRHS:1.74[1.18-2.50]; Health ABC: 1.79[1.17-.274]) were beneficial.

Conclusion: Social connections maybe potentially important and modifiable factors in both preventing and reversing progression of frailty in older adults.