Combined Social Frailty and Life-Space Activities Associated with Risk of Disability: A Prospective Cohort Study

Abstract Objectives: To examine the association between social frailty and life-space activities and determine whether higher life-space activities decreased risk of disability among older adults with social frailty. Design: A prospective cohort study. Setting and Participants: Participants were 8,301 older adults (mean age 72.9 ± 5.6 years, women [53.3%]) from a community setting. Methods: Life-space activities were evaluated using Active Mobility Index (AMI) to assess activities in each life-space (distance from the respondent’s home: up to 1 km, 1–10 km, or greater than 10 km) during the past 1 month. Activities were also assessed according to physical or social activity. Social frailty and characteristics were measured at baseline. Incident disability was assessed according to Long Term Care Insurance. Results: Lower AMI scores (total score, physical score, social score) were associated with social frailty. During the follow-up (mean 23.5 months), 330 participants had incident disability. Incident disability was associated with social frailty. Combined status of social frailty and low AMI increased the risk of disability, which referred to non-frailty and higher AMI. Further, AMI impacted risk of disability in social frailty. Conclusions and Implications: Social frailty or reduced activity in life-space assessment were identified as risk factors for incident disability. Increased activity was observed to modulate the risk of disability among older adults with social frailty. To decrease risk of disability, the development of an intervention program to enhance activities is required.