Social Frailty May Affect Nearly 1 in 4 Older Adults Globally

The prevalence of social frailty in older adults worldwide is high, according to a systematic review and meta-analysis published in the Journal of the American Medical Directors Association.

“Our study found that [social frailty] was influenced by country, settings, and the assessment tools,” wrote a team of nursing researchers in China. “However, it is clear that public health professionals and policymakers need to take social frailty among older adults seriously.”

The investigation into social frailty, a recent concept addressing a person’s risk or actual loss of social resources, social behaviors, social activities, and ability to fulfill social needs, included 43 studies with 83,907 participants 60 years or older.

Overall, the pooled prevalence of social frailty in older adults was 23.9%, according to the study. By setting, the pooled prevalence was higher in hospitals (47.3%) and lower in the community (18.8%).

“This may be because older adult patients in hospital tended to do fewer social activities because of their illness or condition, and were in poorer physical condition, than people living in the community,” researchers wrote. “Hospitalized older adults are also more likely to have negative emotions.”

The prevalence of social frailty in older adults differed among studies that used different assessment instruments. The pooled prevalence of social frailty was 32.3% in 6 studies that used the Tilburg Frailty Indicator, 27.7% in 26 studies that used the Makizako Social Frailty Index, 13.4% in 4 studies that used the Social Frailty Screening Index, and 8.8% in 7 studies that used other assessment tools, researchers reported.

Limited studies of community-dwelling older adults in individual countries that used a range of assessment instruments suggested social frailty was lowest in China (4.9%), followed by Spain (11.6%), Japan (16.2%), Korea (26.6%), 5 European cities (29.2%), and the Netherlands (27.2%). 

“Future clinical trials or cohort studies are needed to evaluate the best intervention and strategies for reducing the prevalence of social frailty,” researchers advised.

Reference:
Zhang XM, Cao S, Gao M, Xiao S, Xie X, Wu X. The prevalence of social frailty among older adults: a systematic review and meta-analysis. J Am Med Dir Assoc. 2023;24(1):29-37.e9. doi:10.1016/j.jamda.2022.10.007