Frailty and social network among older Brazilian adults: evidence from ELSI-Brazil.

Abstract

To investigate the elements of the social network associated with frailty syndrome in older Brazilian adults.

Baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2015-2016) were used. Frailty was defined by the Fried phenotype (unintentional weight loss, exhaustion, weakness, slowness, and low level of physical activity). The social network was assessed using the conceptual model of Berkman and Krishna (social network structure, characteristics of social network ties, social support, and negative social interaction). Potential confounding variables included sociodemographic (age, sex, education, self-reported race, per capita family income, and place of residence) and health characteristics (polypharmacy, multimorbidity, depression, falls, hospitalization, and cognitive function). Analyses were based on multinomial logistic regression.

Among the 8,629 participants, 53.5% were pre-frail individuals and 9.1% were frail individuals. The elements of the social network that were consistently associated with pre-frailty and frailty were the following: characteristics of social network ties, social support, and negative social interaction. A positive association was found for less-than-weekly frequency of virtual contact with sons and daughters (OR = 1.15; 95%CI 1.01-1.33 for pre-frailty and OR = 1.51; 95%CI 1.13-2.02 for frailty) and for loneliness (OR = 1.36; 95%CI 1.19-1.56 for pre-frailty and OR = 1.40; 95%CI 1.12-1.75 for frailty). A negative association was found for social support (help with loans) (OR = 0.75; 95%CI 0.60-0.94 for pre-frailty and OR = 0.54; 95%CI 0.40-0.74 for frailty). However, the perception of criticism was only associated with frailty (OR = 1.35; 95%CI 1.11-1.64).

Social network is an important element for reducing/preventing frailty in older adults. Therefore, public policies and health and social assistance professionals should encompass the older adults' social network regarding the characteristics of social network ties, social support, and negative social interaction.