Social Frailty in Community-Dwelling Older Adults as a Risk Factor for Disability.
OBJECTIVE
To determine social frailty status using simple questions and to examine the association between social frailty and disability onset among community-dwelling older adults.


METHODS
Prospective cohort study.


METHODS
Japanese community.


METHODS
A total of 4304 adults age ≥65 years living in the community participated in a baseline assessment from 2011 to 2012. They were followed monthly for incident certification of care needs during the 2 years after the baseline assessment.


METHODS
Care-needs certification in the national long-term care insurance system of Japan; a self-reported questionnaire including 7 items to define social frailty status, adjustment for several potential confounders such as demographic characteristics; and Kaplan-Meier survival curves for disability incidence by social frailty.


RESULTS
During the 2 years, 144 participants (3.3%) were certified as requiring long-term care insurance in accordance with incident disability. Five of the 7 items in the self-reported questionnaire were significantly associated with disability incidence. In the adjusted model including potential covariates, participants who were defined as having social frailty (≥2/5) (hazard ratio 1.66, 95% confidence interval 1.00-2.74) and prefrailty (=1/5) (hazard ratio 1.53, 95% confidence interval 1.02-2.531), based on 5 items at the baseline assessment, had an increased risk of disability compared with nonfrail participants (=0/5).


CONCLUSIONS
Social frailty, assessed using simple questions regarding living alone, going out less frequently compared with the prior year, visiting friends sometimes, feeling helpful to friends or family, and talking with someone every day, has a strong impact on the risk of future disability among community-dwelling older people.
Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan. Electronic address: makizako@ncgg.go.jp.
Hyuma
H
Makizako
Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.
Hiroyuki
H
Shimada
Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.
Kota
K
Tsutsumimoto
Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.
Sanyoon
S
Lee
Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.
Takehiko
T
Doi
Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.
Sho
S
Nakakubo
Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.
Ryo
R
Hotta
Research Institute of Aging and Development, Oberlin University, Tokyo, Japan.
Takao
T
Suzuki
D000368:Aged; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D057187:Independent Living; D007398:Interpersonal Relations; D007564:Japan; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D012934:Social Isolation
Frailty; disability; long-term care; social activity; social relationship; social role