Combined Impact of Physical Frailty and Social Isolation on Rate of Falls in Older Adults

Objectives: The aim of this study was to examine the impact of the combination of physical frailty and social isolation on falling in community-dwelling older adults. Design: A cross-sectional study of data obtained at registration in a randomized control trial. Setting: Community-based study of participants recruited from Toyota, Japan. Participants: 380 community-dwelling older adults (47.9% women, mean age = 72.3 ± 4.6 years). Measurements: Participants were categorized as non-frail or pre-frail/frail based on the Fried frailty criteria (slowness, weakness, exhaustion, low activity, and weight loss). Social isolation was examined using the Lubben Social Network Scale (LSNS-6), and scores lower than 12 points indicated social isolation. Participants were divided into four groups depending on pre-frail/frail status and social isolation, and experiences of multiple falls over the past year were compared between the groups. Results: Participants were classified into robust (n = 193), physical frailty (PF; n = 108), social isolation (SI; n = 43), and PF with SI (PF+SI; n = 36) groups. A total of 38 (10.0%) participants reported multiple falls. Logistic regression analysis showed that PF and SI groups were not independently associated with falling (PF: OR 1.64, 95% CI 0.65–4.16, SI: OR 2.25, 95% CI 0.77–6.58), while PF+SI group was significantly associated with falling compared with the robust group (OR 3.06, 95% CI 1.00–9.34, p = 0.049) after controlling for confounding factors. Conclusion: Our findings support the assertion that coexistence with physical frailty and social isolation were associated with falling in the older adults.