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Research article
Lin Chen
Beijing Normal University at Zhuhai
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4024-6112
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Geriatrics.
Background: Previous literature has reported that loneliness is a strong predictor of frailty risk. However, less is known about the role of loneliness in frailty transition types. This study aimed to examine whether and how loneliness are related to frailty transition among older Chinese people.
Methods: Our study used participants (aged ≥60 years) from 2008/2009, 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Loneliness was assessed by a single question asking how often the respondent feels lonely. The FRAIL Scale was created to measure physical frailty for our study, and frailty was also assessed by a broader definition of the frailty index. Frailty transition as an outcome variable has been designed as two types according to the measurement of frailty.
Results: Greater loneliness at baseline reduced the possibility of remaining in a robust or prefrail physical frailty state after 3 years (OR=0.78, 95%CI: 0.68–0.91, p<0.01). Greater loneliness was associated with an increased risk of worsening physical frailty over time: compared with those who had never felt lonely, the odds ratios for people who often felt lonely were 1.19 (95%CI: 1.01–1.41, p<0.05) after 3 years and 1.34 (95%CI: 1.08–1.66, p<0.01) after 6 years. The association between loneliness and change in the frailty index differed in the survey periods: loneliness at baseline was found to increase the possibility of participants remaining in frailty (seldom loneliness: OR= 1.78, 95%CI: 1.25–2.55, p<0.01; often loneliness: OR= 1.74, 95%CI: 1.21–2.50, p<0.01) after 6 years, but no significance was shown in the 3-year follow up. Additionally, loneliness at baselines was significantly associated with frailty transition at follow up among the male participants. However, a similar association was not observed among the female participants.
Conclusion: Older people with a high level of loneliness tend to be frail in the future, and greater loneliness is related to an increased risk of worsening frailty and remaining frail. Male elderly with a high level of loneliness were more likely to have a worse frailty transition than female elderly in China.
Keywords
loneliness, frailty, frailty transition, longitudinal, older people, gender difference
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CURRENT STATUS: Published
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Posted 17 Aug, 2020
Published
On 24 Aug, 2020
No community comments so far
Editorial decision: Accept
On 17 Aug, 2020
Editor assigned
On 13 Aug, 2020
Submission checks complete
On 12 Aug, 2020
Editor invited
On 12 Aug, 2020
No comments provided
Editor assigned
On 24 Jul, 2020
Submission checks complete
On 23 Jul, 2020
Editor invited
On 23 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 17 Jul, 2020
Editor assigned
On 06 Jul, 2020
Submission checks complete
On 05 Jul, 2020
Editor invited
On 05 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 18 Jun, 2020
Review #2 received
Received 06 Jun, 2020
Review #1 received
Received 21 May, 2020
Reviewer #2 agreed
On 19 May, 2020
Editor assigned
On 14 May, 2020
Reviewers invited
Invitations sent on 14 May, 2020
Reviewer #1 agreed
On 14 May, 2020
Submission checks complete
On 13 May, 2020
Editor invited
On 13 May, 2020
Community comments: 1
Editorial decision: Major revision
On 16 Apr, 2020
Review #3 received
Received 09 Apr, 2020
Reviewer #3 agreed
On 10 Feb, 2020
Review #2 received
Received 10 Jan, 2020
Review #1 received
Received 26 Dec, 2019
Reviewer #2 agreed
On 04 Dec, 2019
Reviewer #1 agreed
On 28 Nov, 2019
Reviewers invited
Invitations sent on 07 Nov, 2019
Submission checks complete
On 19 Sep, 2019
Editor assigned
On 20 Aug, 2019
Editor invited
On 19 Aug, 2019
First submitted
On 16 Aug, 2019
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Subject Areas
Geriatrics & Gerontology
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This preprint is under consideration at BMC Geriatrics. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Lin Chen
Beijing Normal University at Zhuhai
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4024-6112
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 5
Posted 17 Aug, 2020
Published
On 24 Aug, 2020
No community comments so far
Editorial decision: Accept
On 17 Aug, 2020
Editor assigned
On 13 Aug, 2020
Submission checks complete
On 12 Aug, 2020
Editor invited
On 12 Aug, 2020
No comments provided
Editor assigned
On 24 Jul, 2020
Submission checks complete
On 23 Jul, 2020
Editor invited
On 23 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 17 Jul, 2020
Editor assigned
On 06 Jul, 2020
Submission checks complete
On 05 Jul, 2020
Editor invited
On 05 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 18 Jun, 2020
Review #2 received
Received 06 Jun, 2020
Review #1 received
Received 21 May, 2020
Reviewer #2 agreed
On 19 May, 2020
Editor assigned
On 14 May, 2020
Reviewers invited
Invitations sent on 14 May, 2020
Reviewer #1 agreed
On 14 May, 2020
Submission checks complete
On 13 May, 2020
Editor invited
On 13 May, 2020
Community comments: 1
Editorial decision: Major revision
On 16 Apr, 2020
Review #3 received
Received 09 Apr, 2020
Reviewer #3 agreed
On 10 Feb, 2020
Review #2 received
Received 10 Jan, 2020
Review #1 received
Received 26 Dec, 2019
Reviewer #2 agreed
On 04 Dec, 2019
Reviewer #1 agreed
On 28 Nov, 2019
Reviewers invited
Invitations sent on 07 Nov, 2019
Submission checks complete
On 19 Sep, 2019
Editor assigned
On 20 Aug, 2019
Editor invited
On 19 Aug, 2019
First submitted
On 16 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Geriatrics.
Background: Previous literature has reported that loneliness is a strong predictor of frailty risk. However, less is known about the role of loneliness in frailty transition types. This study aimed to examine whether and how loneliness are related to frailty transition among older Chinese people.
Methods: Our study used participants (aged ≥60 years) from 2008/2009, 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Loneliness was assessed by a single question asking how often the respondent feels lonely. The FRAIL Scale was created to measure physical frailty for our study, and frailty was also assessed by a broader definition of the frailty index. Frailty transition as an outcome variable has been designed as two types according to the measurement of frailty.
Results: Greater loneliness at baseline reduced the possibility of remaining in a robust or prefrail physical frailty state after 3 years (OR=0.78, 95%CI: 0.68–0.91, p<0.01). Greater loneliness was associated with an increased risk of worsening physical frailty over time: compared with those who had never felt lonely, the odds ratios for people who often felt lonely were 1.19 (95%CI: 1.01–1.41, p<0.05) after 3 years and 1.34 (95%CI: 1.08–1.66, p<0.01) after 6 years. The association between loneliness and change in the frailty index differed in the survey periods: loneliness at baseline was found to increase the possibility of participants remaining in frailty (seldom loneliness: OR= 1.78, 95%CI: 1.25–2.55, p<0.01; often loneliness: OR= 1.74, 95%CI: 1.21–2.50, p<0.01) after 6 years, but no significance was shown in the 3-year follow up. Additionally, loneliness at baselines was significantly associated with frailty transition at follow up among the male participants. However, a similar association was not observed among the female participants.
Conclusion: Older people with a high level of loneliness tend to be frail in the future, and greater loneliness is related to an increased risk of worsening frailty and remaining frail. Male elderly with a high level of loneliness were more likely to have a worse frailty transition than female elderly in China.
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