Prevention of frailty in relation with social out-of-home activities in older adults: results from the Survey of Health, Ageing, and Retirement in Europe.

Out-of-home mobility and social participation have been identified as resources to postpone frailty. We aim to examine the mediating role and specific contribution of social out-of-home activities in frailty prevention. Data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) waves six (w6), seven (w7), and eight (w8) were used. Frailty was measured with the SHARE version of the Edmonton Frail Scale (EFS) with frailty states fit, pre-fail and frail. First, a mediation model with 13,456 fit participants aged ≥ 50 years in w6 was specified with social network size, loneliness (UCLA 3-Item Loneliness Scale), and lack of motivation (EURO-D) as predictors and number of performed social out-of-home activities in w7 as mediator variable on EFS-scores in w8. Age, education, gender, cohabitation, widowhood, urban environment, and country served as covariates. Second, we investigated the association of increasing social out-of-home activities from w6 to w7 with change in EFS-score from w6 to w8 using a linear mixed model with 17,439 participants in all frailty states. Direct effects of loneliness (w6) and lack of motivation (w6) on EFS-scores (w8) were partially mediated by social out-of-home activities (loneliness ß = 0.005; 95% CI = 0.003-0.008) and (lack of motivation ß = 0.014; 95% CI = 0.009-0.019). The linear mixed model revealed a significant effect of increasing social out-of-home activities (w6-w7) on reduction of EFS-scores (w8) (ß = - 0.21; 95% CI = - 0.29-0.04; p < 0.001). Social out-of-home activities appear to play a crucial role in frailty prevention, which could be used for future interventions.