Social isolation and loneliness as risk factors
for the progression of frailty
Social relationships are important for health . Most such
research has focused on social isolation or loneliness. Social
isolation is defined objectively using criteria such as having
few contacts, little involvement in social activities and living
alone. Loneliness is a subjective feeling of dissatisfaction
with one’s social relationships. Both social isolation and
loneliness have been linked with increased mortality ,
incident heart disease and functional decline .
Social isolation and loneliness tend to be correlated, albeit
weakly .
Frailty is a clinical syndrome whose main feature is heightened vulnerability to stressors due to lowered physiological
reserves, decline in the ability to maintain homoeostasis and
impairments in multiple systems . There are two principal
models. In Fried’s phenotype model, frailty is based on three
or more components of poor grip strength, slow walking
speed, low physical activity, exhaustion and unintentional
weight loss . The frailty index, or cumulative deficit model, defines frailty in terms of the accumulation of ‘deficits’
(symptoms, signs, diseases and disabilities). A frailty index
score reflects the proportion of potential deficits present . The phenotype model defines frailty in physical terms,
whereas the cumulative deficit model uses a broader definition of frailty.
CATHARINE R. GALE, LEO WESTBURY, CYRUS COOPER
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