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Social isolation and loneliness as risk factors for the progression of frailty: the English Longitudinal Study of Ageing
Open accessAbstract
Background: loneliness and social isolation have been associated with mortality and with functional decline in older people. We investigated whether loneliness or social isolation are associated with progression of frailty. Methods: participants were 2,817 people aged ≥60 from the English Longitudinal Study of Ageing. Loneliness was assessed at Wave 2 using the Revised UCLA scale (short version). A social isolation score at Wave 2 was derived from data on living alone, frequency of contact with friends, family and children, and participation in social organisations. Frailty was assessed by the Fried phenotype of physical frailty at Waves 2 and 4, and by a frailty index at Waves 2-5. Results: high levels of loneliness were associated with an increased risk of becoming physically frail or pre-frail around 4 years later: relative risk ratios (95% CI), adjusted for age, sex, level of frailty and other potential confounding factors at baseline were 1.74 (1.29, 2.34) for pre-frailty, and 1.85 (1.14, 2.99) for frailty. High levels of loneliness were not associated with change in the frailty index-a broadly based measure of general condition-over a mean period of 6 years. In the sample as a whole, there was no association between social isolation and risk of becoming physically frail or pre-frail, but high social isolation was associated with increased risk of becoming physically frail in men. Social isolation was not associated with change in the frailty index. Conclusion: older people who experience high levels of loneliness are at increased risk of becoming physically frail.
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Cites
Frailty in Older Adults: Evidence for a Phenotype
Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., Seeman, T., Tracy, R., Kop, W. J., Burke, G., et al. (2001) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/56.3.m146 · Cited by 24,907 · cited 3×
“We used data from Waves 2 and 4 to derive the phenotype of physical frailty [11].”
BackgroundMethodClegg, A., Young, J., Iliffe, S., Rikkert, M. O., & Rockwood, K. (2013) · The Lancet · doi:10.1016/s0140-6736(12)62167-9 · Cited by 9,503
Social Relationships and Health
House, J. S., Landis, K. R., & Umberson, D. (1988) · Science · doi:10.1126/science.3399889 · Cited by 7,073 · cited 1×
“Social relationships are important for health [1].”
Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review
Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015) · Perspectives on Psychological Science · doi:10.1177/1745691614568352 · Cited by 6,043
A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies
Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004) · Research on Aging · doi:10.1177/0164027504268574 · Cited by 4,781 · cited 1×
“Participants completed the short version of the Revised UCLA loneliness scale [19], which enquires about frequency of feeling left out, isolated, and lacking companionship.”
MethodFrailty Consensus: A Call to Action
Morley, J. E., Vellas, B. J., van Kan, G. A., Anker, S. D., Bauer, J. M., Bernabei, R., Cesari, M., Chumlea, W. C., Doehner, W., Evans, J., et al. (2013) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2013.03.022 · Cited by 4,201 · cited 1×
“definition of frailty inherent in the cumulative deficit model which describes the general state or condition of an individual rather than a specific medical syndrome [30].”
BackgroundA standard procedure for creating a frailty index
Searle, S. D., Mitnitski, A., Gahbauer, E. A., Gill, T. M., & Rockwood, K. (2008) · BMC Geriatrics · doi:10.1186/1471-2318-8-24 · Cited by 3,568 · cited 1×
“It is recommended that at least 30 deficits are included [21].”
BackgroundFrailty in relation to the accumulation of deficits
Rockwood, K., & Mitnitski, A. (2007) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/62.7.722 · Cited by 3,076 · cited 2×
“A frailty index score reflects the proportion of potential deficits present [12].”
BackgroundSocial isolation, loneliness, and all-cause mortality in older men and women
Steptoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2013) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1219686110 · Cited by 2,503 · cited 1×
“Social isolation and loneliness tend to be correlated, albeit weakly [9].”
BackgroundCohort profile: The English longitudinal study of ageing
Steptoe, A., Breeze, E., Banks, J., & Nazroo, J. (2013) · International Journal of Epidemiology · doi:10.1093/ije/dys168 · Cited by 1,779
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Cited by
Sorted by citations
Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management
Dent, E., Morley, J. E., Cruz-Jentoft, A. J., Woodhouse, L. J., Rodríguez‐Mañas, L., Fried, L. P., Woo, J., Aprahamian, I., Sanford, A. M., Lundy, J., et al. (2019) · The journal of nutrition health & aging · doi:10.1007/s12603-019-1273-z · Cited by 1,135
“Social isolation is a major risk factor for the progression of frailty in older adults (167, 168).”
Oral frailty and its determinants in older age: a systematic review
Dibello, V., Zupo, R., Sardone, R., Lozupone, M., Castellana, F., Dibello, A., Daniele, A., Pergola, G. D., Bortone, I., Lampignano, L., et al. (2021) · The Lancet Healthy Longevity · doi:10.1016/s2666-7568(21)00143-4 · Cited by 371
Association between oral health and frailty: A systematic review of longitudinal studies
Hakeem, F. F., Bernabé, E., & Sabbah, W. (2019) · Gerodontology · doi:10.1111/ger.12406 · Cited by 344
COVID-19 in older people: a rapid clinical review
Lithander, F. E., Neumann, S., Tenison, E., Lloyd, K., Welsh, T. J., Rodrigues, J. C. L., Higgins, J. P. T., Scourfield, L., Christensen, H., Haunton, V. J., et al. (2020) · Age and Ageing · doi:10.1093/ageing/afaa093 · Cited by 251
“[99] investigated the association between loneliness and pre-frailty and frailty in 2,346 English older adults and found multivariable adjusted relative risk ratios of 1.”
BackgroundChawla, K., Kunonga, P., Stow, D., Barker, R., Craig, D., & Hanratty, B. (2021) · PLoS ONE · doi:10.1371/journal.pone.0255088 · Cited by 245
Davies, K., Maharani, A., Chandola, T., Todd, C. J., & Pendleton, N. (2021) · The Lancet Healthy Longevity · doi:10.1016/s2666-7568(20)30038-6 · Cited by 219
The Rise of Artificial Intelligence under the Lens of Sustainability
Khakurel, J., Penzenstadler, B., Porras, J., Knutas, A., & Zhang, W. (2018) · Technologies · doi:10.3390/technologies6040100 · Cited by 187
“Researchers [70] have linked social isolation with increased mortality, incidence of heart disease, and functional decline.”
BackgroundDoody, P., Lord, J. M., Greig, C. A., & Phillips, A. C. (2022) · Gerontology · doi:10.1159/000528561 · Cited by 212
Mehrabi, F., & Béland, F. (2020) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2020.104119 · Cited by 195
Lu, X., Yao, Y., & Jin, Y. (2022) · eClinicalMedicine · doi:10.1016/j.eclinm.2022.101708 · Cited by 170
Dibello, V., Lobbezoo, F., Lozupone, M., Sardone, R., Ballini, A., Berardino, G., Mollica, A., Coelho‐Júnior, H. J., Pergola, G. D., Stallone, R., et al. (2022) · GeroScience · doi:10.1007/s11357-022-00663-8 · Cited by 181
Neves, B. B., Sanders, A., & Kokanović, R. (2019) · Journal of Aging Studies · doi:10.1016/j.jaging.2019.100785 · Cited by 181
The relationship between frailty and social vulnerability: a systematic review
Hanlon, P., Wightman, H., Politis, M., Kirkpatrick, S., Jones, C. E., Andrew, M. K., Vetrano, D. L., Dent, E., & Hoogendijk, E. O. (2024) · The Lancet Healthy Longevity · doi:10.1016/s2666-7568(23)00263-5 · Cited by 146
A Systematic Review of Frailty Trajectories: Their Shape and Influencing Factors
Welstead, M., Jenkins, N. D., Russ, T. C., Luciano, M., & Terrera, G. M. (2020) · The Gerontologist · doi:10.1093/geront/gnaa061 · Cited by 158
Frailty Combined with Loneliness or Social Isolation: An Elevated Risk for Mortality in Later Life
Hoogendijk, E. O., Smit, A. P., van Dam, C. S., Schuster, N. A., de Breij, S., Holwerda, T. J., Huisman, M. A., Dent, E., & Andrew, M. K. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16716 · Cited by 152
“At the same time, loneliness was identified as a risk factor for incident frailty.(17) It is therefore likely that frailty and loneliness or social isolation often exist simultaneously.”
BackgroundChen, A., Ge, S., Cho, S., Teng, A. K., Chu, F., Demiris, G., & Zaslavsky, O. (2020) · Geriatric Nursing · doi:10.1016/j.gerinurse.2020.08.001 · Cited by 132
Sarcopenia and Frailty in PD: Impact on Mortality, Malnutrition, and Inflammation
Kamijo, Y., Kanda, E., Ishibashi, Y., & Yoshida, M. (2018) · Peritoneal Dialysis International · doi:10.3747/pdi.2017.00271 · Cited by 133
Multidimensional Approach to Frailty
Wleklik, M., Uchmanowicz, I., Jankowska, E. A., Vitale, C., Lisiak, M., Drozd, M., Pobrotyn, P., Tkaczyszyn, M., & Lee, C. S. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00564 · Cited by 131
Marital Status and Risk of Physical Frailty: A Systematic Review and Meta-analysis
Kojima, G., Walters, K. R., Iliffe, S., Taniguchi, Y., & Tamiya, N. (2019) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2019.09.017 · Cited by 126
Loneliness in Primary Care Patients: A Prevalence Study
Mullen, R. A., Tong, S., Sabo, R. T., Liaw, W. R., Marshall, J., Nease, D. E., Krist, A. H., & Frey, J. J. (2019) · The Annals of Family Medicine · doi:10.1370/afm.2358 · Cited by 115
“(%) Married 668 (54) 307 (58) 361 (51) Widowed/separated/divorced 279 (22) 109 (21) 170 (24) Never married 158 (13) 59 (11) 99 (14) In a relationship 118 (10) 49 (9) 69 (10) Prefer not to answer 16 (1) 7 (1) 9 (1) Location, No.”
Assessing the social dimension of frailty in old age: A systematic review
Bessa, B., Ribeiro, Ó. M., & Coelho, T. (2018) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2018.06.005 · Cited by 122
Jarach, C. M., Tettamanti, M., Nobili, A., & D’Avanzo, B. (2020) · Age and Ageing · doi:10.1093/ageing/afaa168 · Cited by 112
“The ELSA study [17] found no association of social isolation with frailty after adjusting for several factors, corresponding mostly to the variables introduced in our models, suggesting that the significant effect of social isolation in our analysis is not due to insufficient adjustment.”
MethodResultIs living alone a risk factor of frailty? A systematic review and meta-analysis
Kojima, G., Taniguchi, Y., Kitamura, A., & Fujiwara, Y. (2020) · Ageing Research Reviews · doi:10.1016/j.arr.2020.101048 · Cited by 109
Multimorbidity, Loneliness, and Social Isolation. A Systematic Review
Hajek, A., Kretzler, B., & König, H. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17228688 · Cited by 115
“It should be emphasized that these social needs are associated with physical frailty and subsequent mortality [3,4].”
BackgroundNakou, A., Dragioti, E., Bastas, N. S., Ζαγοριανάκου, Ν., Kakaidi, V., Tsartsalis, D., Mantzoukas, S., Tatsis, F., Veronese, N., Solmi, M., et al. (2025) · Aging Clinical and Experimental Research · doi:10.1007/s40520-024-02925-1 · Cited by 140
“Notably, elevated levels of loneliness, but not necessarily social isolation, have been linked to an increased likelihood of physical frailty [27, 28].”
Arlati, S., Colombo, V. M., Spoladore, D., Greci, L., Pedroli, E., Serino, S., Cipresso, P., Goulene, K., Stramba‐Badiale, M., Riva, G., et al. (2019) · Sensors · doi:10.3390/s19020261 · Cited by 101
“Therefore, it is crucial that interventions developed for the improvement of frailty take into account the social aspect, as it is a key element to promote wellbeing and to prevent the onset of social isolation, depression, and low quality of life [33,34].”
BackgroundChanges in activity levels, physical functioning, and fall risk during the COVID ‐19 pandemic
Hoffman, G. J., Malani, P., Solway, E. S., Kirch, M., Singer, D., & Kullgren, J. T. (2021) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17477 · Cited by 101
Ge, L., Yap, C. W., & Heng, B. H. (2022) · BMC Geriatrics · doi:10.1186/s12877-021-02745-2 · Cited by 112
“Prior research has suggested that the association of social isolation and loneliness with frailty is bi-directional with the exact causal mechanism uncertain: while frailty gives rise to greater social isolation and loneliness [22, 23], social isolation and loneliness may also lead to increased risk of frailty [22, 24…”
BackgroundHong, J. H., Nakamura, J. S., Berkman, L. F., Chen, F. S., Shiba, K., Chen, Y., Kim, E. S., & VanderWeele, T. J. (2023) · SSM - Population Health · doi:10.1016/j.ssmph.2023.101459 · Cited by 110
“A growing number of studies have begun examining loneliness and social isolation simultaneously, which has helped understand how they are differentially related to health and well-being outcomes (Beller & Wagner, 2018; Beridze et al., 2020; Bu et al., 2020; Cassie et al., 2020; Christiansen et al., 2021; Coyle & Dugan…”
BackgroundLoneliness as a risk factor for care home admission in the English Longitudinal Study of Ageing
Hanratty, B., Stow, D., Moore, D. C., Valtorta, N., & Matthews, F. E. (2018) · Age and Ageing · doi:10.1093/ageing/afy095 · Cited by 97
“Recent analysis of data from ELSA has added evidence of an association between high levels of loneliness and progression to physical frailty [24].”
Fostering healthy aging: The interdependency of infections, immunity and frailty
Vetrano, D. L., Triolo, F., Maggi, S., Malley, R., Jackson, T., Poscia, A., Bernabei, R., Ferrucci, L., & Fratiglioni, L. (2021) · Ageing Research Reviews · doi:10.1016/j.arr.2021.101351 · Cited by 97
“These same characteristics have been shown to be involved in the development and progression of frailty, suggesting the possibility to act on common risk factors and pointing at the need to study these phenomena under a common framework (Feng et al., 2017; Gale et al., 2018; Trevisan et al., 2020).”
Saur, N. M., Davis, B. R., Montroni, I., Shahrokni, A., Rostoft, S., Russell, M. M., Mohile, S. G., Suwanabol, P. A., Lightner, A. L., Poylin, V. Y., et al. (2022) · Diseases of the Colon & Rectum · doi:10.1097/dcr.0000000000002410 · Cited by 91
Sun, J., Kong, X., Li, H., Chen, J., Yao, Q., Li, H., Zhou, F. L., & Hu, H. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-03219-9 · Cited by 97
“Moreover, social isolation is typically defined as having less or infrequent social contacts [13].”
BackgroundKojima, G., Taniguchi, Y., Aoyama, R., & Tanabe, M. K. G. (2022) · Ageing Research Reviews · doi:10.1016/j.arr.2022.101705 · Cited by 95
Progression of frailty as measured by a cumulative deficit index: A systematic review
Kaskirbayeva, D., West, R., Jaafari, H., King, N. V., Howdon, D., Shuweihdi, F., Clegg, A. P., & Nikolova, S. (2022) · Ageing Research Reviews · doi:10.1016/j.arr.2022.101789 · Cited by 90
Luo, F., Guo, L., Thapa, A., & Yu, B. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.01.022 · Cited by 94
Niederstrasser, N. G., Rogers, N. T., & Bandelow, S. (2019) · PLoS ONE · doi:10.1371/journal.pone.0223799 · Cited by 85
“Loneliness was a significant predictor of incidence and progression of frailty, corroborating previous findings [67,68].”
ResultWard, M. D., May, P., Normand, C. E. M., Kenny, R. A., & Nolan, A. (2021) · Age and Ageing · doi:10.1093/ageing/afab004 · Cited by 93
“Some previous studies have compared the effect of both loneliness and social isolation on health outcomes, including frailty [4,5], and mortality [10], and the authors of the social asymmetry metric found that the combination of low loneliness and high social isolation was predictive of cognitive performance cross-sec…”
BackgroundUncovering the impact of loneliness in ageing populations: a comprehensive scoping review
Puyané, M., Chabrera, C., Luis, E. C., & Cabrera, E. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-05846-4 · Cited by 135
“Gale 2018 [40] High loneliness was linked to a higher risk of becoming frail or pre-frail within four years, though it did not impact frailty index changes over six years.”
Elbogen, E. B., Lanier, M., Griffin, S. C., Blakey, S. M., Gluff, J. A., Wagner, H. R., & Tsai, J. (2022) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2021.0257 · Cited by 79
“15,20 Although some of these issues may naturally resolve upon future lifting of social distancing measures end at the conclusion of the COVID-19 pandemic, this issue will remain important in the future as it is likely that many workplaces will adopt a hybrid model of in-person and…”
Factors associated with social isolation in community-dwelling older adults: a cross-sectional study
Merchant, R. A., Liu, G., Lim, J. Y., Fu, X., & Chan, Y. H. (2020) · Quality of Life Research · doi:10.1007/s11136-020-02493-7 · Cited by 75
Factors Associated With Social Isolation in Older Adults: A Systematic Review and Meta-Analysis
Wen, Z., Peng, S., Yang, L., Wang, H., Liao, X., Liang, Q., & Zhang, X. (2022) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2022.11.008 · Cited by 78
Jung, H., Kim, M., Lee, Y., & Won, C. W. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17217883 · Cited by 72
“Poor social participation can lead to social isolation and loneliness as well as frailty among older adults [59].”
BackgroundXie, B., Ma, C., Chen, Y., & Wang, J. (2020) · Health & Social Care in the Community · doi:10.1111/hsc.13092 · Cited by 74
Xie, B., & Ma, C. (2021) · Maturitas · doi:10.1016/j.maturitas.2021.06.015 · Cited by 71
Tcymbal, A., Abu‐Omar, K., Hartung, V., Bußkamp, A., Comito, C., Roßmann, C., Meinzinger, D., & Reimers, A. K. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.1048496 · Cited by 93
Frailty and depression: Reciprocal influences or common causes?
Mayerl, H., Stolz, E., & Freidl, W. (2020) · Social Science & Medicine · doi:10.1016/j.socscimed.2020.113273 · Cited by 71
Early identification of frailty: Developing an international delphi consensus on pre-frailty
Sezgin, D., O’Donovan, M. R., Woo, J., Bandeen‐Roche, K., Liotta, G., Fairhall, N., Rodríguez‐Laso, Á., Apóstolo, J., Clarnette, R., Holland, C., et al. (2021) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2021.104586 · Cited by 68
Chen, W. L., Shuxian, W., Ling, L., & Renzaho, A. M. N. (2019) · Australian and New Zealand Journal of Public Health · doi:10.1111/1753-6405.12856 · Cited by 67
Takashima, R., Onishi, R., Saeki, K., & Hirano, M. (2020) · Healthcare · doi:10.3390/healthcare8040450 · Cited by 70
“More specifically, living alone is an indicator of social isolation [32], and previous studies have repeatedly pointed out that living alone is a risk factor for loneliness in older adults [33,34].”
BackgroundElliQ, an AI-Driven Social Robot to Alleviate Loneliness: Progress and Lessons Learned
Broadbent, E., Loveys, K., Ilan, G., Chen, G., Chilukuri, M. M., Boardman, S. G., Doraiswamy, P. M., & Skuler, D. (2024) · Journal of Aging Research and Lifestyle · doi:10.14283/jarlife.2024.2 · Cited by 73
“Loneliness significantly increases the risk of physical and mental morbidity (9) and has been associated with declines in cognitive capacity and increased frailty (9, 10) as well as mortality (11).”
BackgroundLoneliness as a risk factor for frailty transition among older Chinese people
Sha, S., Xu, Y., & Chen, L. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01714-5 · Cited by 68
Cudjoe, T., Prichett, L. M., Szanton, S. L., Roberts, L., & Thorpe, R. J. (2022) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17795 · Cited by 64
Zhao, M., Gao, J., Li, M., & Wang, K. (2019) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2018.11.007 · Cited by 61
Malicka, B., Skośkiewicz−Malinowska, K., & Kaczmarek, U. (2022) · BMC Geriatrics · doi:10.1186/s12877-021-02716-7 · Cited by 60
“It was found that high levels of loneliness, but not of social isolation, increased the risk of becoming physically frail [41].”
BackgroundGrover, S., Avasthi, A., Sahoo, S., Lakdawala, B. M., Dan, A., Nebhinani, N., Dutt, A., Tiwari, S., Gania, A., Subramanyam, A. A., et al. (2018) · Journal of Geriatric Mental Health · doi:10.4103/jgmh.jgmh_26_18 · Cited by 65
Follmann, A., Schollemann, F., Arnolds, A., Weismann, P., Laurentius, T., Rossaint, R., & Czaplik, M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18094846 · Cited by 60
“In addition, social isolation and loneliness were associated as higher risk factors for progression of frailty [14] and mortality [15].”
BackgroundCoelho‐Júnior, H. J., Uchida, M. C., Picca, A., Bernabei, R., Landi, F., Calvani, R., Cesari, M., & Marzetti, E. (2021) · Aging Clinical and Experimental Research · doi:10.1007/s40520-021-01802-5 · Cited by 66
Li, L. (2024) · Globalization and Health · doi:10.1186/s12992-024-01056-6 · Cited by 61
“At the same time, loneliness and social isolation would be confirmed to accelerate the progression of frailty based on the population from ELSA [47].”
BackgroundMaltby, J., Hunt, S., Ohinata, A., Palmer, E. J., & Conroy, S. (2020) · Journal of Aging and Health · doi:10.1177/0898264320923245 · Cited by 59
“Loneliness, as an indicator of isolation in the ageing literature, has been linked to a number of health states: heart attacks, strokes, dementia, hospital admissions, and premature deaths (Dreyer et al., 2018; Gale et al., 2018; Hanratty et al., 2018; Kuiper et al., 2015; Shiovitz-Ezra & Ayalon, 2010).”
BackgroundMethodInfluentialSaito, M., Aida, J., Cable, N., Zaninotto, P., Ikeda, T., Tsuji, T., Koyama, S., Noguchi, T., Osaka, K., & Kondo, K. (2020) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.14118 · Cited by 60
Social Isolation, Loneliness and Their Relationships with Mental Health Status in South Korea
Kim, M. H., An, J. H., Lee, H., Jeong, S., Hwang, S. J., & Hong, J. P. (2021) · Psychiatry Investigation · doi:10.30773/pi.2021.0067 · Cited by 58
Kojima, G., Aoyama, R., & Tanabe, M. K. G. (2022) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2022.06.012 · Cited by 58
Interventions aimed at loneliness and fall prevention reduce frailty in elderly urban population
Ožić, S., Vasiljev, V., Ivković, V., Bilajac, L., & Rukavina, T. (2020) · Medicine · doi:10.1097/md.0000000000019145 · Cited by 53
Yu, B., Steptoe, A., Niu, K., & Jia, X. (2020) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2020.06.029 · Cited by 59
Hsu, H. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17249181 · Cited by 62
“[15] found that those who are socially isolated (no social contact and no social group participation) were more likely to be lonely.”
Sha, S., Pan, Y., Xu, Y., & Chen, L. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-03044-0 · Cited by 52
“They found that higher loneliness was significantly associated with an increased risk of becoming frail or prefrail in follow-up [16]; (2) two other longitudinal studies assessed frailty in the PFP scale and the FRAIL scale, and measured loneliness using the Revised UCLA Loneliness Scale and one-single question, respe…”
MethodYang, Y., Zeng, D., & Yang, F. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191912087 · Cited by 49
“At the same time, the individual characteristics of the elderly group, such as the reduction of personal economic resources, deteriorating physical health, cognitive decline, and other factors, will reduce the elderly’s social participation and increase their risk of social isolation [8,9].”
BackgroundEllwood, A., Quinn, C., & Mountain, G. A. (2021) · Research on Aging · doi:10.1177/01640275211045603 · Cited by 50
“, 2017), while positive attitudes to ageing appear to decrease the risk of frailty associated decline (Gale et al., 2018).”
BackgroundFreer, K., & Wallington, S. L. (2019) · British Journal of Community Nursing · doi:10.12968/bjcn.2019.24.10.486 · Cited by 47
Long, R. M., Terracciano, A., Sutin, A. R., Creaven, A., Gerstorf, D., D’Arcy-Bewick, S., & O’Súilleabháin, P. S. (2022) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001151 · Cited by 50
“All three aspects of social health are associated with a number of adverse health outcomes such as depression (21,22), frailty (23,24), poorer cognitive”
BackgroundElderly caregivers of the elderly: frailty, loneliness and depressive symptoms
dos Santos‐Orlandi, A. A., Brígola, A. G., Ottaviani, A. C., Luchesi, B. M., Souza, É. N., de Moura, F. G., Cardoso, J. D. F. Z., Terassi, M., de Oliveira, N. A., & Pavarini, S. C. I. (2019) · Revista Brasileira de Enfermagem · doi:10.1590/0034-7167-2018-0137 · Cited by 43
“The authors concluded that older people experiencing loneliness are at greater risk of becoming frail(13).”
BackgroundResultInfluentialLenze, E. J., Nicol, G. E., Barbour, D. L., Kannampallil, T., Wong, A. W. K., Piccirillo, J., Drysdale, A. T., Sylvester, C. M., Haddad, R., Miller, J. P., et al. (2021) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.200042 · Cited by 43
The prevalence of social frailty among older adults: A systematic review and meta-analysis
Yu, S., Wang, J., Zeng, L., Yang, P., Tang, P., & Su, S. (2022) · Geriatric Nursing · doi:10.1016/j.gerinurse.2022.11.009 · Cited by 44
Ségaux, L., Broussier, A., Oubaya, N., Leissing-Desprez, C., Laurent, M., Naga, H., Fromentin, I., David, J., & Bastuji‐Garin, S. (2021) · Scientific Reports · doi:10.1038/s41598-021-88410-5 · Cited by 41
Yoshida, Y., Iwasa, H., Ishioka, Y., & Suzukamo, Y. (2021) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.14151 · Cited by 40
Social frailty in community-dwelling older adults: a scoping review
Huang, C., Sirikul, W., & Buawangpong, N. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-05971-0 · Cited by 39
“Social frailty is associated with other related concepts, such as loneliness, social isolation, social vulnerability (SV), and resilience, highlighting the need for a holistic approach to understanding it [9–11].”
Community asset participation and social medicine increases qualities of life
Munford, L. A., Panagioti, M., Bower, P., & Skevington, S. M. (2020) · Social Science & Medicine · doi:10.1016/j.socscimed.2020.113149 · Cited by 39
Yuan, Y., Lapane, K. L., Tjia, J., Baek, J., Liu, S., & Ulbricht, C. M. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-03012-8 · Cited by 39
Social anxiety and loneliness among older adults: a moderated mediation model
Sun, S., Wang, Y., Wang, L., Lu, J., Li, H., Zhu, J., Qian, S., Zhu, L., & Xu, H. (2024) · BMC Public Health · doi:10.1186/s12889-024-17795-5 · Cited by 45
“Previous research has shown that higher levels of loneliness may predict frailty, depression, cognitive decline, an increased risk of cardiovascular disease, suicide, and mortality [6–8].”
BackgroundDamme, J. V., Neiterman, E., Oremus, M., Lemmon, K., & Stolee, P. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-1459-6 · Cited by 42
A gradual separation from the world: a qualitative exploration of existential loneliness in old age
Carr, S., & Fang, C. (2021) · Ageing and Society · doi:10.1017/s0144686x21001252 · Cited by 40
Ensuring Sustainable Digital Inclusion among the Elderly: A Comprehensive Analysis
Mohan, R., Saleem, F., Voderhobli, K., & Sheikh-Akbari, A. (2024) · Sustainability · doi:10.3390/su16177485 · Cited by 37
Frailty measurement in research and clinical practice: An updated review
Dent, E., Hanlon, P., Kowal, P. R., & Hoogendijk, E. O. (2025) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2025.106595 · Cited by 42
Combined Impact of Physical Frailty and Social Isolation on Rate of Falls in Older Adults
Hayashi, T., Umegaki, H., Makino, T., Huang, C., Inoue, A., Shimada, H., & Kuzuya, M. (2020) · The journal of nutrition health & aging · doi:10.1007/s12603-020-1316-5 · Cited by 37
“Moreover, high levels of social isolation are associated with an increased risk of becoming physically frail (23), possibly increasing the severity of physical frailty in those who have a combination of physical frailty and social isolation.”
Zhang, Y., Xu, X.-J., Lian, T., Huang, L., Zeng, J., Liang, D., Yin, M., Huang, J., Xiu, L., Yu, Z., et al. (2020) · Aging · doi:10.18632/aging.102671 · Cited by 37
“found that a high level of loneliness was associated with an increased risk of becoming physically frail [21].”
BackgroundVlachantoni, A., Evandrou, M., Falkingham, J., & Qin, M. (2022) · The Gerontologist · doi:10.1093/geront/gnac033 · Cited by 58
“This concept relates to human health and wellbeing, which can affect psychological processes influencing physiological functioning, resulting in increased morbidity and mortality (Hawkley & Cacioppo, 2010; Steptoe et al., 2013; Gale et al., 2018; Jarach et al., 2021; Wenger et al., 1996).”
Ward, M. D., Briggs, R., McGarrigle, C. A., Looze, C. D., O’Halloran, A. M., & Kenny, R. A. (2022) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5856 · Cited by 39
Li, Z., Gu, J., Li, P., Hu, J., Wang, S., Wang, P., Zhou, L., Yun, Y., Shi, Y. X., & Wang, P. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-04666-2 · Cited by 40
“Social frailty is an important dimension of frailty, which means that individuals continue to lose one or more important resources to meet their basic social needs [1, 2].”
BackgroundChen, M., Cao, X. G., Wang, A., Zhu, Y., Lu, G., Li, Z., & Shen, L. (2023) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2023.105211 · Cited by 39
Willis, P. B., Vickery, A., & Jessiman, P. (2020) · Ageing and Society · doi:10.1017/s0144686x20000914 · Cited by 44
Hu, S., Jin, C., & Li, S. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-02815-z · Cited by 33
“In addition, studies have also found that social factors such as social isolation [25], frequency of interaction with relatives and friends [26], and social support [27] were associated with frailty.”
BackgroundMehrabi, F., Pomeroy, M. L., Cudjoe, T., Jenkins, E., Dent, E., & Hoogendijk, E. O. (2024) · Age and Ageing · doi:10.1093/ageing/afae215 · Cited by 33
“Few longitudinal studies have yielded mixed findings [25–27], and none have explored both the reciprocal and temporal sequence of relationships among social isolation, loneliness, and frailty over an extended period.”
BackgroundMethodResultInfluentialAssociation between Social Support and Frailty among Older People with Depressive Disorders
Anantapong, K., Wiwattanaworaset, P., & Sriplung, H. (2020) · Clinical Gerontologist · doi:10.1080/07317115.2020.1728002 · Cited by 33
Social Isolation/loneliness and Mobility Disability Among Older Adults
Tomida, K., Shimoda, T., Nakajima, C., Kawakami, A., & Shimada, H. (2024) · Current Geriatrics Reports · doi:10.1007/s13670-024-00414-x · Cited by 32
“Numerous prior studies have linked social isolation and loneliness among older adults with various adverse outcomes, including cognitive impairment [19], dementia [20], frailty [21], cardiovascular disease [22], functional impairment [23], and mortality [24].”
Strategies of socially isolated older adults: Mechanisms of emergence and persistence
Machielse, A., & Duyndam, J. (2020) · Journal of Aging Studies · doi:10.1016/j.jaging.2020.100852 · Cited by 34
Frailty in patients with interstitial lung disease
Guler, S. A., & Ryerson, C. J. (2020) · Current Opinion in Pulmonary Medicine · doi:10.1097/mcp.0000000000000692 · Cited by 34
Garner, I. W., Varey, S., Navarro‐Pardo, E., Marr, C., & Holland, C. (2022) · Health & Social Care in the Community · doi:10.1111/hsc.13735 · Cited by 32
“…is likely to have an immediate and lasting effect on older adults’ health, with pre- pandemic evidence linking low exercise and social engagement to increased risk of frailty, cognitive decline, and dementia (Apóstolo et al., 2018; Gale et al., 2018; Livingston et al., 2020; Oliveira et al., 2020).”
BackgroundWillis, P., & Vickery, A. (2022) · Health & Social Care in the Community · doi:10.1111/hsc.13732 · Cited by 35
Li, J., Li, J., Chen, Y., Yang, S., Li, Z., Li, W., Gui, Z., & Zhou, C. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.045 · Cited by 33
“Social isolation scores were positively skewed, we defined social isolation as social index score ≥ 1 (Gale et al., 2018).”
Metadata
- Authors
- Gale, C. R., Westbury, L., & Cooper, C.
- Affiliations
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Unit (GB)
- Venue
- Age and Ageing
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-12-22
- Volume
- 47
- Issue
- 3
- Pages
- 392-397
- ISSN
- 0002-0729 (ISSN-L)
- 1468-2834
- PMC
- PMC5920346
- OpenAlex
- W2794981433
- Cited by
- 590
- References
- 30
- Citations by year
- 2026: 67 · 2025: 91 · 2024: 107 · 2023: 77 · 2022: 83 · 2021: 74 · 2020: 57 · 2019: 24 · 2018: 10
- FWCI
- 15.04
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Age and Ageing (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- Funders
- National Institute of Aging in the United States
- UK government
- ELSA
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- loneliness, social isolation, frailty progression, pre-frailty, frailty index, older adults, physical frailty, sex differences, social networks, functional decline
- MeSH terms
- Frailty, Aged, England, Family Relations, Female, Humans, Loneliness, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Risk Factors, Social Isolation, Time Factors, Geriatric Assessment, Prevalence, Marital Status, Disease Progression, Risk Assessment, Friends, Social Participation
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