Independent and Combined Relationships of Perceived Neighborhood Social Cohesion and Physical Frailty on Functional Disability in Community-Dwelling Older Adults

Abstract

Functional disability and physical frailty (PF) are debilitating geriatric conditions. Previous studies have suggested both perceived neighborhood social cohesion (PNSC) and PF can influence functional disability and may have an interactive effect too. This cross-sectional study aims to examine the independent and combined relationships of PF and PNSC on functional disability in community-dwelling older adults in Shanghai, China. A total of 1616 older adults aged 75 years were recruited using multistage sampling. Results showed that prefrailty, frailty (using the modified frailty phenotype criteria), and low PNSC (measured by the Neighborhood Cohesion Scale) were independently associated with increased likelihood of functional disability after adjustment of covariates. To evaluate the combined relationships of PF and PNSC, participants were classified into six groups based on their levels of PF and PNSC. The probability of frail older adults with low PNSC having functional disability stood out compared with the robust older adults with high PNSC. Our findings suggest the importance of high PNSC as a protective factor of maintaining functional ability. Future longitudinal studies are needed to identify the role of PNSC in the development of functional disability among frail older adults.

Perceived neighborhood social cohesion and functional disability among older adults: The moderating roles of sex, physical activity, and multi-morbidity

“…Firstly, with high socially cohesive neighborhoods, older people may have higher odds of getting access to social support when they have health problems [ 36 ]. With access to social support, they can seek early health treatment(s) to prevent the onset of functional disability [ 16 ]. Secondly, social cohesion reduces the development of functional disability through social networking and group activities which result in positive health behaviour such as physical activity and healthy diets [ 37 , 38 ].…”

“…Secondly, social cohesion reduces the development of functional disability through social networking and group activities which result in positive health behaviour such as physical activity and healthy diets [ 37 , 38 ]. Lastly, increased social cohesion is linked to improved mental and physical wellbeing which lessen the functional disability [ 16 , 39 ]. Our results thus suggest that older people with higher socially cohesive neighbourhoods tend to demonstrate better functional and psychological health.…”

“…These studies revealed that older people who report higher levels of perceived social cohesion have a lower chance of developing stroke, and myocardial infarction [ 12 , 13 ]. On the other hand, lower perceived social cohesion through living alone is associated with isolation, reduced social activities and interpersonal ties [ 4 , 14 ], increased likelihood of developing functional disability [ 15 , 16 ], thereby perceived social cohesion acting as protective factor against functional disability. In the study by Stephens, Allen [ 17 ], a greater accessibility of neighborhoods and higher level of trust among neighbours associate with better mental health.…”

Impact of social engagement on the development of sarcopenia among community‐dwelling older adults: A Kashiwa cohort study

“…These studies also suggest that impairing various aspects of social factors might accelerate physical frailty. In the present study, as personal factors related to social engagement, we focused on social network, outings and living space, eating arrangements and perceived neighborhood social cohesion, which have been reported in association with frailty in old age 11‐15 …”

“…In the present study, as personal factors related to social engagement, we focused on social network, outings and living space, eating arrangements and perceived neighborhood social cohesion, which have been reported in association with frailty in old age. [11][12][13][14][15] However, the association of social engagement and related social factors with sarcopenia development among communitydwelling older adults remains unclear. We hypothesized that, among community-dwelling older adults, social engagement would be positively associated with physical activity, nutritional status, oral function and psychological status, and that it would mediate the maintenance of relatively high muscle mass and strength, thus preventing sarcopenia development.…”