title: Adverse effects of frailty on social functioning in older adults: Results from the Longitudinal Aging Study Amsterdam.
abstract: OBJECTIVE
  The aim of this study was to examine the association between physical frailty and social functioning among older adults, cross-sectionally and prospectively over 3 years.
  
  
  METHODS
  The study sample consisted of 1115 older adults aged 65 and over from two waves of the Longitudinal Aging Study Amsterdam, a population based study.
  
  
  METHODS
  Frailty was measured at T1 (2005/2006) using the criteria of the frailty phenotype, which includes weight loss, weak grip strength, exhaustion, slow gait speed and low physical activity. Social functioning was assessed at T1 and T2 (2008/2009) and included social network size, instrumental support, emotional support, and loneliness.
  
  
  RESULTS
  Cross-sectional linear regression analyses adjusted for covariates (age, sex, educational level and number of chronic diseases) showed that pre-frail and frail older adults had a smaller network size and higher levels of loneliness compared to their non-frail peers. Longitudinal linear regression analyses adjusted for covariates and baseline social functioning showed that frailty was associated with an increase in loneliness over 3 years. However, the network size and levels of social support of frail older adults did not further decline over time.
  
  
  CONCLUSIONS
  Frailty is associated with poor social functioning, and with an increase in loneliness over time. The social vulnerability of physical frail older adults should be taken into account in the care provision for frail older adults.
authors.affiliation: Gérontopôle, Department of Internal Medicine and Geriatrics, Toulouse University Hospital, Toulouse, France; Department of General Practice & Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: emielhoogendijk@gmail.com.
authors.forename: Emiel O
authors.initials: EO
authors.lastname: Hoogendijk
authors.affiliation: Department of Sociology, VU University, Amsterdam, The Netherlands. Electronic address: b.a.suanet@vu.nl.
authors.forename: Bianca
authors.initials: B
authors.lastname: Suanet
authors.affiliation: Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, Australia. Electronic address: elsa.dent@unisa.edu.au.
authors.forename: Elsa
authors.initials: E
authors.lastname: Dent
authors.affiliation: Department of Epidemiology & Biostatistics, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: djh.deeg@vumc.nl.
authors.forename: Dorly J H
authors.initials: DJ
authors.lastname: Deeg
authors.affiliation: Department of Sociology, VU University, Amsterdam, The Netherlands. Electronic address: m.j.aartsen@vu.nl.
authors.forename: Marja J
authors.initials: MJ
authors.lastname: Aartsen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D006801:Humans; D008132:Loneliness; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands; D011446:Prospective Studies; D058992:Social Participation; D012944:Social Support
keywords: Frail elderly; Loneliness; Longitudinal study; Social support