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BMC Geriatrics

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01-12-2022 | Addiction | Research

Factors influencing the stages of frailty among Korean older adults focusing on objective and subjective social isolation

Authors: Song Yi Han, Hye Young Jang, Young Ko

Published in: BMC Geriatrics | Issue 1/2022

Abstract

Background

Although many studies have investigated the factors influencing frailty, few studies have confirmed the influence of social factors on the stages of frailty. This study was conducted to identify factors influencing the stages of frailty in Korean older adults, focusing on objective and subjective social isolation.

Methods

This study analyzed the data of 10,041 older adults from the 2017 National Survey of Older Koreans. Two multiple logistic regression analyses were performed to identify the factors influencing the frailty stages. Frailty was calculated using the FRAIL scale with the five domains: fatigue, resistance, ambulation, illness, and loss of weight.

Results

Among Korean older adults, 51.5% were in the robust stage, 42.5% in the pre-frail stage and 6.0% in the frail stage. As a multiple logistic regression analysis, participants with an intimate relationship (Odds ratio (OR) 0.93, 95% Confidential interval (CI) = 0.91–0.95) or objective social non-isolated participants were more likely to be in the robust group than the pre-frail group. Objective social-isolated participants were more likely to belong to the frail group than the pre-frail group: isolation from family member only (OR 1.57, 95% CI = 1.04–2.39), isolation from non-family member only (OR 1.75, 95% CI = 1.39–2.19), and isolation from both family and non-family member (OR 2.56, 95% CI = 1.67–3.92).

Conclusions

This cross-sectional study showed that social isolation was associated with the stage of frailty. Therefore, researchers need to consider issues of social isolation of older adults in the development of frailty prevention and management intervention.

Vermeiren S, Vella-Azzopardi R, Beckwee D, Habbig AK, Scafoglieri A, Jansen B, et al. Frailty and the prediction of negative health outcomes: a meta-analysis. J Am Med Dir Assoc. 2016;17(12):1163.e1-e17. https://doi.org/10.1016/j.jamda.2016.09.010.CrossRef

Jung HW, Kim SW, Ahn S, Lim JY, Han JW, Kim TH, et al. Prevalence and outcomes of frailty in Korean elderly population: comparisons of a multidimensional frailty index with two phenotype models. PLoS ONE. 2014;9(2): e87958.CrossRefPubMedPubMedCentral

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–57. https://doi.org/10.1093/gerona/56.3.M146.CrossRefPubMed

Ahmed N, Mandel R, Fain MJ. Frailty: An emerging geriatric syndrome. Am J Med. 2007;120(9):748–53. https://doi.org/10.1016/j.amjmed.2006.10.018.CrossRefPubMed

Park B, Lee Y. Integrative approach to elderly frailty. Korean J Fam Med. 2010;31:747–54. https://doi.org/10.4082/kjfm.2010.31.10.747.CrossRef

Yang F, Chen QW. Evaluation of frailty and influencing factors in old people in hospital institution: Evidence for a phenotype of frailty. Medicine. 2018;97(3). doi: https://doi.org/10.1097/MD.0000000000009634

Chang YW, Chen WL, Lin FG, Fang WH, Yen MY, Hsieh CC, et al. Frailty and its impact on health-related quality of life: A cross-sectional study on elder community-dwelling preventive health service users. PLoS ONE. 2012;7(5): e38079. https://doi.org/10.1371/journal.pone.0038079.CrossRefPubMedPubMedCentral

Nagai K, Tamaki K, Kusunoki H, Wada Y, Tsuji S, Itoh M, et al. Physical frailty predicts the development of social frailty: a prospective cohort study. BMC Geriatr. 2020;20(1):1–8.CrossRef

Abizanda P, Romero L, Sanchez-Jurado PM, Martinez-Reig M, Alfonso-Silguero SA, Rodriguez-Manas L. Age, frailty, disability, institutionalization, multimorbidity or comorbidity. Which are the main targets in older adults?. J Nutr Health Aging. 2014;18(6):622–7.

10.

Shi SM, Olivieri-Mui B, McCarthy EP, Kim DH. Changes in a frailty index and association with mortality. J Am Geriatr Soc. 2020;69(4):1057–62. https://doi.org/10.1111/jgs.17002.CrossRefPubMedPubMedCentral

11.

Niederstrasser NG, Rogers NT, Bandelow S. Determinants of frailty development and progression using a multidimensional frailty index: Evidence from the English Longitudinal Study of Ageing. PLoS ONE. 2019;14(10): e0223799. https://doi.org/10.1371/journal.pone.0223799.CrossRefPubMedPubMedCentral

12.

Ntanasi E, Yannakoulia M, Mourtzi N, Vlachos GS, Kosmidis MH, Anastasiou CA, et al. Prevalence and risk factors of frailty in a community-dwelling population: the HELIAD study. J Aging Health. 2020;32(1):14–24. https://doi.org/10.1177/0898264318801735.CrossRefPubMed

13.

Zhang Y, Xu XJ, Lian TY, Huang LF, Zeng JM, Liang DM, et al. Development of frailty subtypes and their associated risk factors among the community-dwelling elderly population. Aging (Albany NY). 2020;12(2):1128–40. https://doi.org/10.18632/aging.102671.CrossRef

14.

Trevisan C, Veronese N, Maggi S, Baggio G, Toffanello ED, Zambon S, et al. Factors influencing transitions between frailty states in elderly adults: The Progetto Veneto Anziani Longitudinal Study. J Am Geriatr Soc. 2017;65(1):179–84. https://doi.org/10.1111/jgs.14515.CrossRefPubMed

15.

Yoon DH, Hwang SS, Lee DW, Lee CG, Song W. Physical frailty and cognitive functioning in Korea rural community-dwelling older adults. J Clin Med. 2018;7(11):405. https://doi.org/10.3390/jcm7110405.CrossRefPubMedCentral

16.

Furtado GE, Caldo A, Rieping T, Filaire E, Hogervorst E, Teixeira AMB, et al. Physical frailty and cognitive status over-60 age populations: a systematic review with meta-analysis. Arch Gerontol Geriatr. 2018;78:240–8.CrossRefPubMed

17.

Makizako H, Shimada H, Doi T, Tsutsumimoto K, Hotta R, Nakakubo S, et al. Social frailty leads to the development of physical frailty among physically non-frail adults: a four-year follow-up longitudinal cohort study. Int J Environ Res Public Health. 2018;15(3):490. https://doi.org/10.3390/ijerph15030490.CrossRefPubMedCentral

18.

Maltby J, Hunt SA, Ohinata A, Palmer E, Conroy S. Frailty and social isolation: comparing the relationship between frailty and unidimensional and multifactorial models of social isolation. J Aging Health. 2020;32(10):1297–308. https://doi.org/10.1177/0898264320923245.CrossRefPubMedPubMedCentral

19.

Hoogendijk EO, Suanet B, Dent E, Deeg DJ, Aartsen MJ. Adverse effects of frailty on social functioning in older adults: results from the Longitudinal Aging Study Amsterdam. Maturitas. 2016;83:45–50. https://doi.org/10.1016/j.maturitas.2015.09.002.CrossRefPubMed

20.

Mehrabi F, Béland F. Effects of social isolation, loneliness and frailty on health outcomes and their possible mediators and moderators in community-dwelling older adults: a scoping review. Arch Gerontol Geriatr. 2020;90: 104119. https://doi.org/10.1016/j.archger.2020.104119.CrossRefPubMed

21.

Taylor RJ, Taylor HO, Chatters LM. Social isolation from extended family members and friends among African Americans: findings from a national survey. J Fam Soc Work. 2016;19:443–61.CrossRefPubMedPubMedCentral

22.

Taylor HO, Taylor RJ, Nguyen AW, Chatters L. Social isolation, depression, and psychological distress among older adults. J Aging Health. 2018;30(2):229–46. https://doi.org/10.1177/0898264316673511.CrossRefPubMed

23.

Carstensen LL, Isaacowitz DM, Charles ST. Taking time seriously: a theory of socioemotional selectivity. Am Psychol. 1999;54(3):165–81.CrossRefPubMed

24.

Hawkley LC, Wroblewski K, Kiaser T, Luhmann M, Schumm LP, Are US. older adults getting lonelier? age, period, and cohort differences. Psychol Aging. 2019;8:1144–57. https://doi.org/10.1037/pag000365.CrossRef

25.

Korea Institute for Health and Social Affairs. National Survey of Older Koreans. Ministry of Health and Welfare: Sejong, Korea. 2017;2017:27–39.

26.

van Kan GA, Rolland YM, Morley JE, Vellas B. Frailty: toward a clinical definition. J Am Med Dir Assoc. 2008;9(2):71–2. https://doi.org/10.1016/j.jamda.2007.11.005.CrossRef

27.

Jung HW, Yoo HJ, Park SY, Kim SW, Choi JY, Yoon SJ, et al. The Korean version of the FRAIL scale: clinical feasibility and validity of assessing the frailty status of Korean elderly. Korean J Intern Med. 2016;31:594–600. https://doi.org/10.3904/kjim.2014.331.CrossRefPubMed

28.

Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging. 2012;16:601–8. https://doi.org/10.1007/s12603-012-0084-2.CrossRefPubMedPubMedCentral

29.

Won CW, Yang KY, Rho YG, Kim SY, Lee EJ, Yoon JL, et al. The development of Korean Activities of Daily Living (K-ADL) and Korean Instrumental Activities of Daily Living (K-IADL) scale. J Korean Geriatr Soc. 2002;6:107–20.

30.

Kim GW, Kim MH, Kim BG, Kim JR, Kim TH, Moon SW, et al. Standardization of diagnostic tools for dementia. Research Report. Gyeonggido, Seongnam: Bundang Seoul National University Hospital; 2009 December. Report No.: 11–1351000–000589–01.

31.

Chen S, Honda T, Narazaki K, Chen T, Kishimoto H, Haeuchi Y, et al. Physical frailty is associated with longitudinal decline in global cognitive function in non-demented older adults: a prospective study. J Nutr Health Aging. 2018;22(1):82–8. https://doi.org/10.1007/s12603-017-0924-1.CrossRefPubMed

32.

Cheong CY, Nyunt MSZ, Gao Q, Gwee X, Choo RWM, Yap KB, et al. Risk factors of progression to frailty: findings from the Singapore Longitudinal Ageing Study. J Nutr Health Aging. 2020;24(1):98–106. https://doi.org/10.1007/s12603-019-1277-8.CrossRefPubMed

33.

Jarach CM, Tettamanti M, Nobili A, D’avanzo B. Social isolation and loneliness as related to progression and reversion of frailty in the Survey of Health Aging Retirement in Europe (SHARE). Age Ageing. 2021;50(1):258–62. https://doi.org/10.1093/ageing/afaa168.CrossRefPubMed

34.

Schrempft S, Jackowska M, Hamer M, Steptoe A. Associations between social isolation, loneliness, and objective physical activity in older men and women. BMC Public Health. 2019;19(1):74. https://doi.org/10.1186/s12889-019-6424-y.CrossRefPubMedPubMedCentral

35.

Crimmins EM, Preston SH, Cohen B, editors; Panel on Understanding Divergent Trends in Longevity in High-Income Countries; Report of the National Research Council of the National Academies. Explaining Divergent Levels of Longevity in High-Income Countries. Washington, DC: The National Academies Press, 2011.

36.

Kim SH, Park S, Park KS. Correlates of successful aging in South Korean older adults: a meta-analytic review. Asia Pac J Public Health. 2017;29(7):544–59. https://doi.org/10.1177/1010539517717021.CrossRefPubMed

37.

Chung SD. A comparative study on the successful aging for Korean elderly women and elderly men. Journal of the Korean Gerontological Society. 2007;27(4):829–45.

38.

Macdonald SJ, Nixon J, Deacon L. Loneliness in the city: examining socioeconomics, loneliness and poor health in the North East of England. Public Health. 2018;165:88–94. https://doi.org/10.1016/j.puhe.2018.09.003.CrossRefPubMed

39.

Coyle CE, Steinman BA, Chen J. Visual acuity and self-reported vision status. J Aging Health. 2017;29(1):128–48. https://doi.org/10.1177/0898264315624909.CrossRefPubMed

40.

Ejiri M, Kawai H, Ishii K, Oka K, Obuchi S. Predictors of older adults’ objectively measured social isolation: A systematic review of observational studies. Arch Gerontol Geriatr. 2021;94: 104357. https://doi.org/10.1016/j.archger.2021.104357.CrossRefPubMed

41.

Ministry of Health and Welfare, Korea Health Promotion Institute. 2019 Guideline for visiting health care. Seoul: Korea Health Promotion Institute; 2019. pp. 42.

42.

Korea Health Promotion Institute. 2018 Study on the status and direction of development of visiting health care programs. Seoul: Korea Health Promotion Institute, 2020. Report No. 04–2020–003–01.

43.

Stijnen MMN, Jansen MWJ, Vrijhoef HJM, Duimel-Peeters IGP. Development of a home visitation programme for the early detection of health problems in potentially frail community-dewelling older people by general practices. Eur J Ageing. 2012;10:49–60. https://doi.org/10.1007/s10433-012-0251-7.CrossRefPubMedPubMedCentral

44.

Liimatta H, Lampela P, Laitinen-Parkkonen P, Pitkala KH. Effects of preventive home visits on health-related quality-of-life and mortality in home-dwelling older adults. Scand J Prim Health Care. 2019;37(1):90–7. https://doi.org/10.1080/02813432.2019.1569372.CrossRefPubMedPubMedCentral

45.

Kono A, Kanaya Y, Fujita T, Tsumura C, Kondo T, Kushiyama K, et al. Effects of a preventive home visit program in ambulatory frail older people: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2012;67(3):302–9. https://doi.org/10.1093/gerona/glr176.CrossRefPubMed

46.

Lee DO, Chin YR. The follow-up study of changes in frailty in elderly receiving home health care of the public health center. J Korean Acad Community Health Nurs. 2019;30(4):528–38. https://doi.org/10.12799/jkachn.2019.30.4.528.CrossRef

47.

Shukla A, Harper M, Pedersen E, Goman A, Suen JJ, Price C, et al. Hearing loss, loneliness, and social isolation: a systematic review. Otolaryngol Head Neck Surg. 2020;162(5):622–33. https://doi.org/10.1177/0194599820910377.CrossRefPubMedPubMedCentral

48.

Campos JL, Launer S. (2020). From healthy hearing to healthy living: a holistic approach. Ear Hear. 2020;41 Suppl 1:99S-106S. doi: https://doi.org/10.1097/AUD.0000000000000931.

49.

Fernández-García ÁI, Gómez-Cabello A, Moradell A, Navarrete-Villanueva D, Pérez-Gómez J, Ara I, et al. How to improve the functional capacity of frail and pre-frail elderly people? Health, nutritional status and exercise intervention. the EXERNET-Elder 3.0 project. Sustainability. 2020;12(15):6246. doi:https://doi.org/10.3390/su12156246

50.

Merchant RA, Morley JE, Izquierdo M. Exercise, aging and frailty: guidelines for increasing function. J Nutr Health Aging. 2021;25:1–5.CrossRef

Title: Factors influencing the stages of frailty among Korean older adults focusing on objective and subjective social isolation
Authors: Song Yi Han
Hye Young Jang
Young Ko
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Addiction
Addiction
Published in: BMC Geriatrics / Issue 1/2022
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-022-03179-0

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