This study investigated the association of social isolation with physical activity, sleep status, and physical function in community-dwelling frail older adults.
We conducted a cross-sectional analysis of 56 community-dwelling frail older adults (mean age: 83.3 ± 4.5 years, 75.0% female) who required nursing care and attended an adult day services center. Social isolation was defined as a score of less than 12 on the Six-item Lubben Social Network Scale. Physical activity was evaluated using the Life Space Assessment, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality (PSQI global score). Physical function was measured using the Timed Up-and-Go test and grip strength test. We also assessed the fear of falling (FOF), self-rated health (SRS), and care needs. We performed multivariable logistic regression to examine the association between social isolation and the measured parameters, adjusting for potential confounding factors such as age and sex.
Of the community-dwelling frail older adults, 55.4% were at risk of social isolation. Physical activity (OR = 0.94, 95%CI: 0.90–0.97, p0.001) and sleep quality (OR = 1.27, 95% CI: 1.06–1.51, p = 0.009) were independently associated with social isolation. Additionally, FOF (OR = 0.84, 95%CI: 0.74–0.95, p = 0.005) and SRS (OR = 3.43, 95% CI: 1.05–11.15, p = 0.041) were significantly correlated with social isolation. No significant association was observed between physical function and social isolation.
Approximately half of community-dwelling frail older adults may be at risk of social isolation, highlighting a significant public health concern. These findings suggest that social isolation in this population is significantly associated with physical activity, sleep quality, fear of falling, and self-rated health. Although physical function is also important, it did not show a significant association with social isolation in the present study. These results highlight the need for targeted interventions that address social isolation and its interconnected factors, including physical activity, sleep quality, fear of falling, and self-rated health.
In physical therapy practice, addressing social isolation requires understanding its associated factors among frail older adults. Assessments and interventions for physical activity and sleep status are essential. Additionally, assessing fear of falling and self-assessed health status are important. Understanding these associations may help develop effective interventions to prevent health decline in this vulnerable population.
Frail Older Adults
Sleep Status
