The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.
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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Citations
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
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“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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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
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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