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.

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 (BRHS1.74[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.