A recent study investigates the interconnectedness of social isolation, loneliness, and frailty and how these factors influence each other as individuals age. The researchers discovered that experiencing physical frailty might predict future social isolation, while loneliness can serve as both a precursor to and a result of frailty. Importantly, these three elements can create a cycle: individuals who feel lonely and socially disconnected may become frailer, and as their frailty increases, so does their experience of loneliness and isolation. This effect intensifies with advancing age.
A recent study by a researcher from Concordia looks into how social isolation, loneliness, and frailty are interrelated and how they mutually influence each other as individuals age.
Fereshteh Mehrabi, a postdoctoral fellow in the Department of Psychology, along with her collaborators, discusses these complex relationships in the journal Age and Ageing.
The team analyzed data from seven surveys collecting information from over 2,300 older adults in the Netherlands every three years, spanning from 1995 to 2016. Their findings indicate that physical frailty may signal potential social isolation in the future and that loneliness can both precede and result from frailty.
These three conditions tend to reinforce one another: lonely and socially isolated individuals can become frailer, and as they experience increased frailty, their feelings of isolation and loneliness can worsen. This cycle becomes particularly severe as they age.
“Across six out of the seven data collection points we examined over 18 years, we observed that older adults experiencing frailty are more likely to feel lonely, and in five out of the seven surveys, they also showed signs of social isolation,” explains Mehrabi.
Two decades of data
The data for this study was sourced from the Longitudinal Aging Study Amsterdam, initiated in 1992. Participants averaged 72.6 years of age, with approximately 52 percent being female. Participants were at least 55 years old.
To evaluate social isolation, participants responded to six questions regarding their marital status, living arrangements, frequency of contact with family or friends, and participation in community activities. A higher total score reflected greater social isolation. Mehrabi highlights that this assessment focuses on the quantity of a person’s social connections.
In contrast, loneliness relates to the quality of relationships. To gauge loneliness, participants answered 11 questions focused on the nature of their interpersonal connections. Scaled responses to statements like, “I miss having really close friends,” indicated levels of loneliness, with higher scores reflecting greater feelings of loneliness.
Frailty was evaluated based on self-reported chronic health issues, overall health status, functional limitations—such as the ability to manage tasks independently—physical capabilities, memory issues, and depressive symptoms. It represents a decline in physiological health and resilience following challenging experiences like illness, injury, or recovery from surgery.
Declines are reversible
“It’s crucial to recognize that individuals who are socially isolated often adopt unhealthy lifestyles, such as smoking, poor nutrition, inadequate sleep, and lack of social engagement,” notes Mehrabi.
On a brighter note, she points out that both social isolation and frailty, particularly at the pre-frail stage, can be mitigated through lifestyle modifications like enhanced nutrition, increased physical activity, and participation in community events. Pre-frailty serves as an early warning of physical decline in older adults, characterized by reduced strength, endurance, and mobility.
“Current strategies primarily address loneliness among socially isolated seniors, yet we must also engage those who are frail in social activities,” she suggests.
“For individuals who are pre-frail or frail, we can connect them with local resources, such as libraries for activities or encourage them to try physical exercises like yoga and tai chi.”
“The key objective is to enhance social connections in older adults experiencing pre-frailty.”
The co-authors of this research include Mary Louise Pomeroy and Emerald Jenkins from the Johns Hopkins Bloomberg School of Public Health, Thomas Cudjoe from the Johns Hopkins School of Medicine, Elsa Dent from Flinders University in Adelaide, Australia, and Emiel Hoogendijk from VU University Medical Center in Amsterdam, the Netherlands.
