The relationship between frailty and social vulnerability: a systematic review

Hanlon, P. , Wightman, H., Politis, M., Kirkpatrick, S., Jones, C. , Andrew, M. K., Vetrano, D. L., Dent, E. and Hoogendijk, E. O. (2024) The relationship between frailty and social vulnerability: a systematic review. Lancet Healthy Longevity, 5(3), e214-e226. (doi: 10.1016/S2666-7568(23)00263-5)

Abstract

Both frailty (reduced physiological reserve) and social vulnerability (scarcity of adequate social connections, support, or interaction) become more common as people age and are associated with adverse consequences. Analyses of the relationships between these constructs can be limited by the wide range of measures used to assess them. In this systematic review, we synthesised 130 observational studies assessing the association between frailty and social vulnerability, the bidirectional longitudinal relationships between constructs, and their joint associations with adverse health outcomes. Frailty, across assessment type, was associated with increased loneliness and social isolation, perceived inadequacy of social support, and reduced social participation. Each of these social vulnerability components was also associated with more rapid progression of frailty and lower odds of improvement compared with the absence of that social vulnerability component (eg, more rapid frailty progression in people with social isolation vs those who were not socially isolated). Combinations of frailty and social vulnerability were associated with increased mortality, decline in physical function, and cognitive impairment. Clinical and public health measures targeting frailty or social vulnerability should, therefore, account for both frailty and social vulnerability.

• Item Type: Articles
• Additional Information: Dr Peter Hanlon was funded by a Medical Research Council Clinical Research Training Fellowship (Grant reference MR/S021949/1) entitled “Understanding prevalence and impact of frailty in chronic disease and implications for clinical management.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Jones, Dr Caitlin and Wightman, Ms Heather and Hanlon, Dr Peter
• Authors: Hanlon, P., Wightman, H., Politis, M., Kirkpatrick, S., Jones, C., Andrew, M. K., Vetrano, D. L., Dent, E., and Hoogendijk, E. O.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Lancet Healthy Longevity
• Publisher: Lancet Publishing Group
• ISSN: 2666-7568
• ISSN (Online): 2666-7568
• Published Online: 29 February 2024
• Copyright Holders: Copyright © 2024 The Authors
• First Published: First published in Lancet Healthy Longevity 5(3): e214-e226
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
305232		Understanding prevalence and impact of frailty in chronic illness and implications for clinical management	Frances Mair	Medical Research Council (MRC)	MR/S021949/1	SHW - General Practice & Primary Care