{"id":621266,"date":"2023-03-23T17:49:30","date_gmt":"2023-03-23T22:49:30","guid":{"rendered":"https:\/\/news.sellorbuyhomefast.com\/index.php\/2023\/03\/23\/being-socially-frail-comes-with-health-risks-for-older-adults\/"},"modified":"2023-03-23T17:49:30","modified_gmt":"2023-03-23T22:49:30","slug":"being-socially-frail-comes-with-health-risks-for-older-adults","status":"publish","type":"post","link":"https:\/\/newsycanuse.com\/index.php\/2023\/03\/23\/being-socially-frail-comes-with-health-risks-for-older-adults\/","title":{"rendered":"Being \u2018Socially Frail\u2019 Comes With Health Risks for Older Adults"},"content":{"rendered":"
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Consider three hypothetical women in their mid-70s, all living alone in identical economic circumstances with the same array of ailments: diabetes, arthritis, and high blood pressure.<\/p>\n

Ms. Green stays home most of the time and sometimes goes a week without seeing people. But she\u2019s in frequent touch by phone with friends and relatives, and she takes a virtual class with a discussion group from a nearby college.<\/p>\n

Ms. Smith also stays home, but rarely talks to anyone. She has lost contact with friends, stopped going to church, and spends most of her time watching TV.<\/p>\n

Ms. Johnson has a wide circle of friends and a busy schedule. She walks with neighbors regularly, volunteers at a school twice a week, goes to church, and is in close touch with her children, who don\u2019t live nearby.<\/p>\n

Three sets of social circumstances, three levels of risk should the women experience a fall, bout of pneumonia, or serious deterioration in health.<\/p>\n

Of the women, Ms. Johnson would be most likely to get a ride to the doctor or a visit in the hospital, experts suggest. Several people may check on Ms. Green and arrange assistance while she recovers.<\/p>\n

But Ms. Smith would be unlikely to get much help and more likely than the others to fare poorly if her health became challenged. She\u2019s what some experts would call \u201csocially vulnerable\u201d or \u201csocially frail.\u201d<\/p>\n

Social frailty is a corollary to physical frailty, a set of vulnerabilities (including weakness, exhaustion, unintentional weight loss, slowness, and low physical activity) shown to increase the risk<\/a> of falls, disability, hospitalization, poor surgical outcomes<\/a>, admission to a nursing home, and earlier death in older adults.<\/p>\n

Essentially, people who are physically frail have less physiological strength and a reduced biological ability to bounce back from illness or injury.<\/p>\n

Those who are socially frail similarly have fewer resources to draw upon, but for different reasons \u2014 they don\u2019t have close relationships, can\u2019t rely on others for help, aren\u2019t active in community groups or religious organizations, or live in neighborhoods that feel unsafe, among other circumstances. Also, social frailty can entail<\/a> feeling a lack of control over one\u2019s life or being devalued by others.<\/p>\n

Many of these factors have been linked to poor health outcomes in later life, along with so-called social determinants of health \u2014 low socioeconomic status, poor nutrition, insecure housing, and inaccessible transportation.<\/p>\n

Social frailty assumes that each factor contributes to an older person\u2019s vulnerability and that they interact with and build upon each other. \u201cIt\u2019s a more complete picture of older adults\u2019 circumstances than any one factor alone,\u201d said Dr. Melissa Andrew, a professor of geriatric medicine at Dalhousie University in Halifax, Nova Scotia, who published one of the first social vulnerability indices<\/a> for older adults in 2008.<\/p>\n

This way of thinking about older adults\u2019 social lives, and how they influence health outcomes, is getting new attention from experts in the U.S. and elsewhere. In February, researchers at Massachusetts General Hospital and the University of California-San Francisco published a 10-item \u201csocial frailty index<\/a>\u201d in the Proceedings of the National Academy of Sciences journal.<\/p>\n

Using data from 8,250 adults 65 and older who participated in the national Health and Retirement Study from 2010 to 2016, the researchers found that the index helped predict an increased risk of death during the period studied in a significant number of older adults, complementing medical tools used for this purpose.<\/p>\n

\u201cOur goal is to help clinicians identify older patients who are socially frail and to prompt problem-solving designed to help them cope with various challenges,\u201d said Dr. Sachin Shah, a co-author of the paper and a researcher at Massachusetts General Hospital.<\/p>\n

\u201cIt adds dimensions of what a clinician should know about their patients beyond current screening instruments, which are focused on physical health,\u201d said Dr. Linda Fried, an internationally known frailty researcher and dean of the Mailman School of Public Health at Columbia University.<\/p>\n

Beyond the corridors of medicine, she said, \u201cwe need society to build solutions\u201d to issues raised in the index \u2014 the ability of seniors to work, volunteer, and engage with other people; the safety and accessibility of neighborhoods in which they live; ageism and discrimination against older adults; and more.<\/p>\n

Meanwhile, a team of Chinese researchers recently published a comprehensive review of social frailty<\/a> in adults age 60 and older, based on results from dozens of studies with about 83,900 participants in Japan, China, Korea, and Europe. They determined that 24% of these older adults, assessed both in hospitals and in the community, were socially frail \u2014 a higher portion than those deemed physically frail (12%) or cognitively frail (9%) in separate studies. Most vulnerable were people 75 and older.<\/p>\n

What are the implications for health care? \u201cIf someone is socially vulnerable, perhaps they\u2019ll need more help at home while they\u2019re recovering from surgery. Or maybe they\u2019ll need someone outside their family circle to be an advocate for them in the hospital,\u201d said Dr. Kenneth Covinsky, a geriatrician at UCSF and co-author of the recent Proceedings of the National Academy of Sciences article.<\/p>\n

\u201cI can see a social frailty index being useful in identifying older adults who need extra assistance and directing them to community resources,\u201d said Jennifer Ailshire, an associate professor of gerontology and sociology at the University of Southern California Leonard Davis School of Gerontology.<\/p>\n

Unlike other physicians, geriatricians regularly screen older adults for extra needs, albeit without using a well-vetted or consistent set of measures. \u201cI\u2019ll ask, who do you depend on most and how do you depend on them? Do they bring you food? Drive you places? Come by and check on you? Give you their time and attention?\u201d said Dr. William Dale, the Arthur M. Coppola Family Chair in Supportive Care Medicine at City of Hope, a comprehensive cancer center in Duarte, California.<\/p>\n

Depending on the patients\u2019 answers, Dale will refer them to a social worker or help modify their plan of care. But, he cautioned, primary care physicians and specialists don\u2019t routinely take the time to do this.<\/p>\n

Oak Street Health, a Chicago-based chain of 169 primary care centers for older adults in 21 states and recently purchased by CVS Health, is trying to change that in its clinics, said Dr. Ali Khan, the company\u2019s chief medical officer of value-based care strategy. At least three times a year, medical assistants, social workers, or clinicians ask patients about loneliness and social isolation, barriers to transportation, food insecurity, financial strain, housing quality and safety, access to broadband services, and utility services.<\/p>\n

The organization combines these findings with patient-specific medical information in a \u201cglobal risk assessment\u201d that separates seniors into four tiers of risk, from very high to very low. In turn, this informs the kinds of services provided to patients, the frequency of service delivery, and individual wellness plans, which include social as well as medical priorities.<\/p>\n

The central issue, Khan said, is \u201cwhat is this patient\u2019s ability to continue down a path of resilience in the face of a very complicated health care system?\u201d and what Oak Street Health can do to enhance that.<\/p>\n

What\u2019s left out of an approach like this, however, is something crucial to older adults: whether their relationships with other people are positive or negative. That isn\u2019t typically measured, but it\u2019s essential in considering whether their social needs are being met, said Linda Waite, the George Herbert Mead Distinguished Service Professor of sociology at the University of Chicago and director of the National Social Life, Health, and Aging Project.<\/p>\n

For seniors who want to think about their own social vulnerability, consider this five-item index<\/a>, developed by researchers in Japan.<\/p>\n

(1) Do you go out less frequently now than last year?<\/p>\n

(2) Do you sometimes visit your friends?<\/p>\n

(3) Do you feel you are helpful to friends or family?<\/p>\n

(4) Do you live alone?<\/p>\n

(5) Do you talk to someone every day?<\/p>\n

Think about your answers. If you find your responses unsatisfactory, it might be time to reconsider your social circumstances and make a change.<\/p>\n<\/p><\/div>\n

Read More<\/a>
\n Judith Graham<\/p>\n","protected":false},"excerpt":{"rendered":"

Consider three hypothetical women in their mid-70s, all living alone in identical economic circumstances with the same array of ailments: diabetes, arthritis, and high blood pressure. Ms. Green stays home most of the time and sometimes goes a week without seeing people. But she\u2019s in frequent touch by phone with friends and relatives, and she<\/p>\n","protected":false},"author":1,"featured_media":621267,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1615,34065],"tags":[],"class_list":{"0":"post-621266","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-being","8":"category-socially"},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts\/621266","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/comments?post=621266"}],"version-history":[{"count":0,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts\/621266\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/media\/621267"}],"wp:attachment":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/media?parent=621266"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/categories?post=621266"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/tags?post=621266"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}