Research following more than 15,000 people in England has found that living in precarious social or financial circumstances is a key predictor of frailty in later life.
Researchers at the University of Edinburgh, Harvard Medical School and the University of Strathclyde made the discovery using data from men and women aged over 50 taking part in a long-term study of ageing.
The research received funding from the National Institute for Health and Care Research and the Medical Research Council.
Social risks
The team analysed information on individuals’ finances, employment, pensions, housing, caregiving and relationships collected over a 14-year period as part of the English Longitudinal Study of Ageing.
They used this data to develop a Later Life Precarity Index to assess the social risks that can lead to frailty in older adults.
The team then combined this with data on each adult’s cognitive and physical health, ability in carrying out everyday activities, chronic conditions, and psychological and general health to measure their frailty over time.
Vulnerable conditions
Findings from the study suggest people living in socially vulnerable conditions are at greater risk of developing frailty, in some cases this might be decades earlier, than those with more stable circumstances, and can go on to accumulate higher levels of frailty as they age, the researchers say
As well as low income and limited wealth, factors such as renting in later life, food insecurity, fuel poverty, homelessness, and poor housing quality were identified as having substantial impacts on frailty risk.
This was the case even after accounting for a range of factors, including age, sex, and overall financial circumstances.
In terms of relationship status, being widowed or living alone was associated with small increases in frailty risk, while being divorced showed no significant effect.
Social inequalities
While the study cannot prove that social inequalities directly cause frailty it provides robust evidence that exposure to multiple forms of social precarity is likely a driver of frailty in later life.
The study is among the first to capture the cumulative impact of precarious circumstances across multiple areas of life in older adults.
Researchers say the findings build on their previous research that showed increases in frailty during a period of austerity policies which involved cuts to social services supporting older adults.