Frailty and types of social relationships among older adults in 17 European countries: A latent class analysis

BACKGROUND: Frailty is a syndrome commonly associated with old age. Social relationships are an essential determinant of frailty progression, and frailty can negatively affect social relationships. OBJECTIVES: To identify social relationship types among older adults in Europe; to evaluate whether social relationship types differ across European regions; and to assess the association between frailty status and social relationship type. METHODS: We used data from 56,226 individuals from 17 European countries who participated in Wave 6 of the Survey of Health, Ageing and Retirement in Europe. We constructed social relationship types from social relationship variables (contacts frequency, perceived emotional support, participation in social activities, providing and receiving instrumental support) using latent class analysis (LCA). Associations between social relationship types and frailty were examined using multinomial regression analyses integrated with LCA. RESULTS: We identified four social relationship types: 'poor'; 'frequent and emotionally close'; 'frequent, emotionally close, and supportive'; and 'frequent, emotionally close, and active'. Type 3 is also characterised by participation in sport/social clubs (in the northern region) or receiving support (in the eastern region). Participation in volunteering/charity activities (in the central and northern regions) and instrumental support provision (in the northern region) are Type 4's characteristics as well. In all regions, being frail was associated with less active social relationships (Types 1, 2, and 3) relative to the more 'active' type (Type 4). CONCLUSION: Frailty status was associated with social relationship types. The identified types may help tailor intervention programmes for older adults to prevent worsening frailty.