Barghouth Muhammad Helmi, Klein Jessica, Bothe Tim, Ebert Natalie, Schaeffner Elke, Mielke Nina
Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
Department of Social Policy and Social Security Studies, Hochschule Bonn-Rhein-Sieg, Sankt Augustin, Germany.
Front Public Health. 2024 Jul 17;12:1408641. doi: 10.3389/fpubh.2024.1408641. eCollection 2024.
Despite the growing evidence regarding the influence of social factors on frailty in older adults, the effect of social support remains unclear. This study aims to assess the association between social support and frailty progression (transition and incidence) in a sample of community-dwelling older adults.
Using a cohort study design, 1,059 older adults from the Berlin Initiative Study were followed up for 2.1 years. Multinomial and logistic regression analyses were performed to assess the association of social support using Oslo Social Support Scale-3 with frailty transition and incidence, respectively. Gender differences were explored using stratified analyses.
At baseline, frailty prevalence in the study population [mean (SD) age 84.3 (5.6) years; 55.8% women] reached 33.1% with 47.0, 29.4 and 23.6% of the participants reporting moderate, strong and poor social support, respectively. Over the follow-up period, social support was not significantly associated with the frailty transition categories in the adjusted model. Conversely, the adjusted logistic regression analysis showed that participants with poor social support had twice the odds of becoming frail compared to those with strong social support (OR 2.07; 95% CI 1.08-3.95). Gender-stratified analyses showed comparable estimates to the main analysis but were statistically non-significant.
Our study results underpin the role of social factors in frailty incidence and highlight social support as a potential target for frailty-preventing interventions in older adults. Therefore, it is important to adopt a biopsychosocial model rather than a purely biomedical model to understand and holistically improve the health of community-dwelling older adults.
尽管越来越多的证据表明社会因素对老年人衰弱有影响，但社会支持的作用仍不明确。本研究旨在评估社区居住的老年人样本中社会支持与衰弱进展（转变和发生率）之间的关联。
采用队列研究设计，对来自柏林倡议研究的1059名老年人进行了2.1年的随访。分别进行多项和逻辑回归分析，以评估使用奥斯陆社会支持量表-3的社会支持与衰弱转变和发生率之间的关联。通过分层分析探讨性别差异。
在基线时，研究人群[平均（标准差）年龄84.3（5.6）岁；55.8%为女性]的衰弱患病率达到33.1%，分别有47.0%、29.4%和23.6%的参与者报告社会支持为中等、强和差。在随访期间，调整模型中社会支持与衰弱转变类别无显著关联。相反，调整后的逻辑回归分析显示，社会支持差的参与者比社会支持强的参与者衰弱的几率高出两倍（比值比2.07；95%置信区间1.08-3.95）。性别分层分析显示与主要分析结果相当，但无统计学意义。
我们的研究结果证实了社会因素在衰弱发生率中的作用，并强调社会支持是老年人衰弱预防干预的潜在目标。因此，采用生物心理社会模型而非单纯的生物医学模型来理解和全面改善社区居住老年人的健康非常重要。
