Frailty as a Moderator of the Relationship between Social Isolation and Health Outcomes in Community-Dwelling Older Adults.


Mehrabi F(1)(2), Béland F(1)(2)(3).
Author information:
(1)School of Public Health
(ESPUM), Université de Montréal, 7071 Parc Ave, Montréal, QC H3N 1X9, Canada.
(2)Centre de Recherche en Santé Publique
(CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 7071 Parc Ave, Montréal, QC H3N 1X9, Canada.
(3)Lady Davis Institute for Medical Research, Jewish General Hospital, 3755, Chemin de la Côte-Ste-Catherine, Montréal, QC H3T 1E2, Canada.


This research investigated the effects of social isolation on frailty and health outcomes and tested whether these associations varied across different levels of frailty. We performed a multivariate analysis of the first wave of Frailty: A longitudinal study of its expressions (FRéLE) among 1643 Canadian older adults aged 65 years and over. We assessed social isolation using social participation, social networks, and support from various social ties, namely, friends, children, extended family, and partner. Frailty was associated with disability, comorbidity, depression, and cognitive decline. Less social participation was associated with limitations in instrumental activities of daily living (IADLs), depression, and cognitive decline. The absence of friends was associated with depression and cognitive impairment. Less social support from children and partner was related to comorbidity, depression, and cognitive decline. Overall, social isolation is linked to mental health rather than physical health. The associations of having no siblings, receiving less support from friends, and participating less in social activities with ADL limitations, depression, and cognitive decline were higher among frail than prefrail and robust older adults. This study corroborates the pivotal role of social connectedness, particularly the quality of relationships, on the mental health of older adults. Public health policies on social relationships are paramount to ameliorate the health status of frail older adults.