Social frailty and the progression and trajectory of physical, psychological and cognitive multimorbidities: a multi-cohort study
1
School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
Popul. Med. 2026;8(Supplement Supplement 1):A3029
ABSTRACT
BACKGROUND:
Social frailty is associated with a series of health outcomes, including physical, psychological and cognitive conditions, while evidence on how social frailty contributed to intricate multimorbidities of these conditions is still lacking. This study aimed to disentangle the dynamic progression of physical, psychological and cognitive conditions and their multimorbidities in relation to social frailty.
METHODS:
This multi-cohort study harmonized individual-level data from four aging studies across 24 countries in the US, Europe and Asia. Participants providing information on social frailty with no pre-existing physical, psychological or cognitive conditions were included in the analysis. Social frailty was assessed through four domains including general resources, social behaviors, social resources, and basic social needs. Information on physical, psychological and cognitive conditions was captured by self-report and study-specific assessments.
RESULTS:
During follow-up of 49,648 person-years, 2,981 (41.9%) individuals progressed from no physical, psychological or cognitive conditions to one of them, 1,592 (22.4%) progressed to multimorbidities. Individuals with social pre-frailty and social frailty have higher incidence rates and hazard ratios of progressing one of the conditions and their multimorbidities than those with no social frailty (hazard ratio=2.10, 1.67 to 2.65), following a dose-dependent manner. Significant associations were also observed for most domains of social frailty. Over time, nearly half of the participants presented trajectories of “increased physical conditions”, “increased physical and psychological conditions”, or “increased physical and cognitive conditions”. Social pre-frailty and social frailty were associated with all the above-mentioned trajectories, with the highest odds for the group of “increased physical and cognitive conditions” (social frailty vs. no social frailty: odds ratio=2.69, 2.11 to 3.44).
CONCLUSIONS:
Social frailty is a significant predictor of physical, psychological and cognitive conditions, as well as further progressing to multimorbidities. Early assessment and actions to address social frailty are important to improve multi-dimensional health in middle-aged and older adults.
Social frailty is associated with a series of health outcomes, including physical, psychological and cognitive conditions, while evidence on how social frailty contributed to intricate multimorbidities of these conditions is still lacking. This study aimed to disentangle the dynamic progression of physical, psychological and cognitive conditions and their multimorbidities in relation to social frailty.
METHODS:
This multi-cohort study harmonized individual-level data from four aging studies across 24 countries in the US, Europe and Asia. Participants providing information on social frailty with no pre-existing physical, psychological or cognitive conditions were included in the analysis. Social frailty was assessed through four domains including general resources, social behaviors, social resources, and basic social needs. Information on physical, psychological and cognitive conditions was captured by self-report and study-specific assessments.
RESULTS:
During follow-up of 49,648 person-years, 2,981 (41.9%) individuals progressed from no physical, psychological or cognitive conditions to one of them, 1,592 (22.4%) progressed to multimorbidities. Individuals with social pre-frailty and social frailty have higher incidence rates and hazard ratios of progressing one of the conditions and their multimorbidities than those with no social frailty (hazard ratio=2.10, 1.67 to 2.65), following a dose-dependent manner. Significant associations were also observed for most domains of social frailty. Over time, nearly half of the participants presented trajectories of “increased physical conditions”, “increased physical and psychological conditions”, or “increased physical and cognitive conditions”. Social pre-frailty and social frailty were associated with all the above-mentioned trajectories, with the highest odds for the group of “increased physical and cognitive conditions” (social frailty vs. no social frailty: odds ratio=2.69, 2.11 to 3.44).
CONCLUSIONS:
Social frailty is a significant predictor of physical, psychological and cognitive conditions, as well as further progressing to multimorbidities. Early assessment and actions to address social frailty are important to improve multi-dimensional health in middle-aged and older adults.
| eISSN: | 2654-1459 |
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