Characteristics of Social Frailty among Older Adults with Intellectual Disability

Abstract

Aim It is increasingly understood that social frailty poses a significant challenge to aging in place for older adults. However, our understanding of this health state is limited to studies involving older adults in the general population. This study aimed to obtain a holistic understanding of the characteristics of social frailty among older adults with intellectual disability including its association with physical frailty and capacity to predict mortality in this population.

Methods The primary data source was the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing. Social frailty was operationalised according to the accumulation of deficits model to construct a Social Frailty Index. The measurement of physical frailty was based on modified phenotypic criteria including grip strength, vitality, unintended weight loss, timed up and go, and physical activity. Characteristics of a social frailty sub-sample were analysed using descriptive statistics. The association between social frailty and physical frailty was evaluated using Venn diagram. Receiver operating characteristic was used to assess the capacity of social frailty to predict mortality over a three-to-six-year timeframe. Multinomial logistic regression was performed to examine the impact of independent variables on social frailty status and mortality.

Results Social frailty was associated with advancing age, female gender, severe/profound level of intellectual disability, the presence of Down syndrome, and living in a congregated setting. Physical frailty was more prevalent in comparison to social frailty, while a significant proportion of the study sample had both physical frailty and social frailty. Risk of high levels of social frailty and mortality was associated with advancing age, the presence of Down syndrome, and living in a congregated setting.

Conclusion Insights obtained may have potentially significant implications for policy and clinical practice. Further research is required to enhance our understanding of social frailty among older adults with intellectual disability.