Associations of social engagement and loneliness with the progression and reversal of frailty: longitudinal investigations of 2 prospective cohorts from the UK and the USA.

Abstract

Social connections may impact the dynamic trajectory of frailty. 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 prefrailty and frailty, as well as their association with reversal to prefrailty and robust status among older adults. 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]) and an 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]) raised 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. Social connections may be potentially important and modifiable factors in both preventing and reversing progression of frailty in older adults.