The association of social frailty with intrinsic capacity in community-dwelling older adults: a prospective cohort study

Background Social frailty is associated with poor health outcomes; however, its effects on healthy aging indicators have not been adequately investigated. This study assessed the longitudinal association between social frailty and the intrinsic capacity of community-dwelling older adults. Methods A total of 663 participants (56.7% women) aged >= 60 years from in Nagoya, Japan, were included in the study. The first measurement occurred in 2014, and annual follow-ups occurred until 2017. Social frailty was determined based on four items: financial difficulty, household status, social activity, and regular contact with others. A deficit score of 0 represented social robustness, 1 represented social prefrailty, and >= 2 represented social frailty. Intrinsic capacity was evaluated by the locomotion, cognition, psychological function, vitality, and sensory function domains. The longitudinal association was analyzed using generalized estimating equations. Results The prevalence of social prefrailty and social frailty at baseline was 31.2 and 6.3%, respectively. The social prefrailty group (beta = - 0.132, P < 0.001) and social frailty group (beta = - 0.258, P < 0.001) were associated with a greater reduction in the composite intrinsic capacity scores than the social robustness group, especially in the cognition, psychological function, and vitality domains. Men with social prefrailty/social frailty demonstrated a greater decrease in the psychological function domain score (- 0.512 vs. - 0.278) than women. Additionally, the cognition domain score only decreased in men in the social prefrailty/social frailty group (beta = - 0.122, P = 0.016). Conclusions Social frailty was associated with intrinsic capacity and its subdomains longitudinally. Men with social frailty were more vulnerable than women to a decline in their psychological function and cognition domains. Therefore, the advanced management of social frailty is necessary to facilitate healthy aging.

Automated summary

This study found a longitudinal association between social frailty and intrinsic capacity in community-dwelling older adults, especially in the cognition, psychological function, and vitality domains. Men with social frailty or prefrailty demonstrated a greater decrease in psychological function and cognition domains. Advanced management of social frailty is necessary for promoting healthy aging.