Combined Impact of Physical Frailty and Social Isolation on Rate of Falls in Older Adults

Objectives The aim of this study was to examine the impact of the combination of physical frailty and social isolation on falling in community-dwelling older adults. Design A cross-sectional study of data obtained at registration in a randomized control trial. Setting Community-based study of participants recruited from Toyota, Japan. Participants 380 community-dwelling older adults (47.9% women, mean age = 72.3 +/- 4.6 years). Measurements Participants were categorized as non-frail or pre-frail/frail based on the Fried frailty criteria (slowness, weakness, exhaustion, low activity, and weight loss). Social isolation was examined using the Lubben Social Network Scale (LSNS-6), and scores lower than 12 points indicated social isolation. Participants were divided into four groups depending on pre-frail/frail status and social isolation, and experiences of multiple falls over the past year were compared between the groups. Results Participants were classified into robust (n = 193), physical frailty (PF; n = 108), social isolation (SI; n = 43), and PF with SI (PF+SI; n = 36) groups. A total of 38 (10.0%) participants reported multiple falls. Logistic regression analysis showed that PF and SI groups were not independently associated with falling (PF: OR 1.64, 95% CI 0.65-4.16, SI: OR 2.25, 95% CI 0.77-6.58), while PF+SI group was significantly associated with falling compared with the robust group (OR 3.06, 95% CI 1.00-9.34, p = 0.049) after controlling for confounding factors. Conclusion Our findings support the assertion that coexistence with physical frailty and social isolation were associated with falling in the older adults.