IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0002232.html
   My bibliography  Save this article

Social Vulnerability, Frailty and Mortality in Elderly People

Author

Listed:
  • Melissa K Andrew
  • Arnold B Mitnitski
  • Kenneth Rockwood

Abstract

Background: Social vulnerability is related to the health of elderly people, but its measurement and relationship to frailty are controversial. The aims of the present study were to operationalize social vulnerability according to a deficit accumulation approach, to compare social vulnerability and frailty, and to study social vulnerability in relation to mortality. Methods and Findings: This is a secondary analysis of community-dwelling elderly people in two cohort studies, the Canadian Study of Health and Aging (CSHA, 1996/7–2001/2; N = 3707) and the National Population Health Survey (NPHS, 1994–2002; N = 2648). Social vulnerability index measures that used self-reported items (23 in NPHS, 40 in CSHA) were constructed. Each measure ranges from 0 (no vulnerability) to 1 (maximum vulnerability). The primary outcome measure was mortality over five (CHSA) or eight (NPHS) years. Associations with age, sex, and frailty (as measured by an analogously constructed frailty index) were also studied. All individuals had some degree of social vulnerability. Women had higher social vulnerability than men, and vulnerability increased with age. Frailty and social vulnerability were moderately correlated. Adjusting for age, sex, and frailty, each additional social ‘deficit’ was associated with an increased odds of mortality (5 years in CSHA, odds ratio = 1.05, 95% confidence interval: 1.02–1.07; 8 years in the NPHS, odds ratio = 1.08, 95% confidence interval: 1.03–1.14). We identified a meaningful survival gradient across quartiles of social vulnerability, and although women had better survival than men, survival for women with high social vulnerability was equivalent to that of men with low vulnerability. Conclusions: Social vulnerability is reproducibly related to individual frailty/fitness, but distinct from it. Greater social vulnerability is associated with mortality in older adults. Further study on the measurement and operationalization of social vulnerability, and of its relationships to other important health outcomes, is warranted.

Suggested Citation

  • Melissa K Andrew & Arnold B Mitnitski & Kenneth Rockwood, 2008. "Social Vulnerability, Frailty and Mortality in Elderly People," PLOS ONE, Public Library of Science, vol. 3(5), pages 1-8, May.
    • Handle: RePEc:plo:pone00:0002232
    DOI: 10.1371/journal.pone.0002232
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0002232
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0002232&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0002232?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Lochner, Kimberly A. & Kawachi, Ichiro & Brennan, Robert T. & Buka, Stephen L., 2003. "Social capital and neighborhood mortality rates in Chicago," Social Science & Medicine, Elsevier, vol. 56(8), pages 1797-1805, April.
    2. Kawachi, I. & Kennedy, B.P. & Lochner, K. & Prothrow-Stith, D., 1997. "Social capital, income inequality, and mortality," American Journal of Public Health, American Public Health Association, vol. 87(9), pages 1491-1498.
    3. Grundy, Emily & Sloggett, Andy, 2003. "Health inequalities in the older population: the role of personal capital, social resources and socio-economic circumstances," Social Science & Medicine, Elsevier, vol. 56(5), pages 935-947, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Oleksandr Didkovskyi & Giovanni Azzone & Alessandra Menafoglio & Piercesare Secchi, 2021. "Social and material vulnerability in the face of seismic hazard: An analysis of the Italian case," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 184(4), pages 1549-1577, October.
    2. Tu N. Nguyen & Patrice Ngangue & Tarek Bouhali & Bridget L. Ryan & Moira Stewart & Martin Fortin, 2019. "Social Vulnerability in Patients with Multimorbidity: A Cross-Sectional Analysis," IJERPH, MDPI, vol. 16(7), pages 1-9, April.
    3. Yi Ge & Guangfei Yang & Yi Chen & Wen Dou, 2019. "Examining Social Vulnerability and Inequality: A Joint Analysis through a Connectivity Lens in the Urban Agglomerations of China," Sustainability, MDPI, vol. 11(4), pages 1-19, February.
    4. Anna Petherick & Rafael Goldszmidt & Eduardo B. Andrade & Rodrigo Furst & Thomas Hale & Annalena Pott & Andrew Wood, 2021. "A worldwide assessment of changes in adherence to COVID-19 protective behaviours and hypothesized pandemic fatigue," Nature Human Behaviour, Nature, vol. 5(9), pages 1145-1160, September.
    5. Sirio Cividino & Gianluca Egidi & Luca Salvati, 2020. "Unraveling the (Uneven) Linkage? A Reflection on Population Aging and Suburbanization in a Mediterranean Perspective," Sustainability, MDPI, vol. 12(11), pages 1-14, June.
    6. Zachary Zimmer & Yasuhiko Saito & Olga Theou & Clove Haviva & Kenneth Rockwood, 2021. "Education, wealth, and duration of life expected in various degrees of frailty," European Journal of Ageing, Springer, vol. 18(3), pages 393-404, September.
    7. Jesús Rodrigo-Comino & Gianluca Egidi & Adele Sateriano & Stefano Poponi & Enrico Maria Mosconi & Antonio Gimenez Morera, 2021. "Suburban Fertility and Metropolitan Cycles: Insights from European Cities," Sustainability, MDPI, vol. 13(4), pages 1-14, February.
    8. Khaksar, Seyed Mohammad Sadegh & Khosla, Rajiv & Chu, Mei Tai & Shahmehr, Fatemeh S., 2016. "Service Innovation Using Social Robot to Reduce Social Vulnerability among Older People in Residential Care Facilities," Technological Forecasting and Social Change, Elsevier, vol. 113(PB), pages 438-453.
    9. Yang Zhou & Ning Li & Wenxiang Wu & Jidong Wu & Peijun Shi, 2014. "Local Spatial and Temporal Factors Influencing Population and Societal Vulnerability to Natural Disasters," Risk Analysis, John Wiley & Sons, vol. 34(4), pages 614-639, April.
    10. Matthew Wilson & Sandi Lane & Raghuveer Mohan & Margaret Sugg, 2020. "Internal and external validation of vulnerability indices: a case study of the Multivariate Nursing Home Vulnerability Index," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 100(3), pages 1013-1036, February.
    11. Giulia Cavrini & Marina Marino & Agostino Stavolo, 2023. "The narrative of the social frailty of the older population in the Italian press," RIEDS - Rivista Italiana di Economia, Demografia e Statistica - The Italian Journal of Economic, Demographic and Statistical Studies, SIEDS Societa' Italiana di Economia Demografia e Statistica, vol. 77(3), pages 104-115, July-Sept.
    12. Maria Gabriella Melchiorre & Carlos Chiatti & Giovanni Lamura & Francisco Torres-Gonzales & Mindaugas Stankunas & Jutta Lindert & Elisabeth Ioannidi-Kapolou & Henrique Barros & Gloria Macassa & Joaqui, 2013. "Social Support, Socio-Economic Status, Health and Abuse among Older People in Seven European Countries," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-10, January.
    13. Silvana Miceli & Laura Maniscalco & Domenica Matranga, 2019. "Social networks and social activities promote cognitive functioning in both concurrent and prospective time: evidence from the SHARE survey," European Journal of Ageing, Springer, vol. 16(2), pages 145-154, June.
    14. Jaekyung Lee & Saheum Hong & Yunmi Park, 2017. "Predictable Surprise: The Spatial and Social Morphology of Aging Suburbs in the U.S. Metropolitan Areas," Sustainability, MDPI, vol. 9(3), pages 1-20, March.
    15. Alexander Fekete, 2019. "Social vulnerability change assessment: monitoring longitudinal demographic indicators of disaster risk in Germany from 2005 to 2015," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 95(3), pages 585-614, February.
    16. Shu-Yu Lin & Wei-Ju Lee & Ming-Yueh Chou & Li-Ning Peng & Shu-Ti Chiou & Liang-Kung Chen, 2016. "Frailty Index Predicts All-Cause Mortality for Middle-Aged and Older Taiwanese: Implications for Active-Aging Programs," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-13, August.
    17. Margie E Lachman & Stefan Agrigoroaei, 2010. "Promoting Functional Health in Midlife and Old Age: Long-Term Protective Effects of Control Beliefs, Social Support, and Physical Exercise," PLOS ONE, Public Library of Science, vol. 5(10), pages 1-9, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Khawaja, Marwan & Abdulrahim, Sawsan & Soweid, Rima A.Afifi. & Karam, Dima, 2006. "Distrust, social fragmentation and adolescents' health in the outer city: Beirut and beyond," Social Science & Medicine, Elsevier, vol. 63(5), pages 1304-1315, September.
    2. Tse-Chuan Yang & Stephen A Matthews, 2015. "Death by Segregation: Does the Dimension of Racial Segregation Matter?," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-26, September.
    3. Zawisza, Katarzyna & Sekuła, Paulina & Gajdzica, Michalina & Tobiasz-Adamczyk, Beata, 2024. "Social capital and all-cause mortality before and during the COVID-19 pandemic among middle-aged and older people: Prospective cohort study in Poland," Social Science & Medicine, Elsevier, vol. 343(C).
    4. Eiji Yamamura, 2011. "Differences in the effect of social capital on health status between workers and non-workers," International Review of Economics, Springer;Happiness Economics and Interpersonal Relations (HEIRS), vol. 58(4), pages 385-400, December.
    5. Blume,L.E. & Durlauf,S.N., 2005. "Identifying social interactions : a review," Working papers 12, Wisconsin Madison - Social Systems.
    6. Fiorillo, Damiano & Sabatini, Fabio, 2015. "Structural social capital and health in Italy," Economics & Human Biology, Elsevier, vol. 17(C), pages 129-142.
    7. Damiano Fiorillo, 2016. "Workers’ health and social relations in Italy," Journal of Economic Studies, Emerald Group Publishing Limited, vol. 43(5), pages 835-862, October.
    8. Jae-Young Lim & Hyun-Hoon Lee & Yeon-Hee Hwang, 2011. "Trust on doctor, social capital and medical care use of the elderly," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(2), pages 175-188, April.
    9. Riumallo-Herl, Carlos Javier & Kawachi, Ichiro & Avendano, Mauricio, 2014. "Social capital, mental health and biomarkers in Chile: Assessing the effects of social capital in a middle-income country," Social Science & Medicine, Elsevier, vol. 105(C), pages 47-58.
    10. Lee, Matthew R., 2010. "The protective effects of civic communities against all-cause mortality," Social Science & Medicine, Elsevier, vol. 70(11), pages 1840-1846, June.
    11. Engström, Karin & Mattsson, Fredrik & Järleborg, Anders & Hallqvist, Johan, 2008. "Contextual social capital as a risk factor for poor self-rated health: A multilevel analysis," Social Science & Medicine, Elsevier, vol. 66(11), pages 2268-2280, June.
    12. Ali, Sadiq M. & Merlo, Juan & Rosvall, Maria & Lithman, Thor & Lindström, Martin, 2006. "Social capital, the miniaturisation of community, traditionalism and first time acute myocardial infarction: A prospective cohort study in southern Sweden," Social Science & Medicine, Elsevier, vol. 63(8), pages 2204-2217, October.
    13. Paul R Ward & Loreen Mamerow & Samantha B Meyer, 2014. "Interpersonal Trust across Six Asia-Pacific Countries: Testing and Extending the ‘High Trust Society’ and ‘Low Trust Society’ Theory," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-17, April.
    14. Diego Zavaleta & Kim Samuel & China T. Mills, 2017. "Measures of Social Isolation," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 131(1), pages 367-391, March.
    15. Xinguang Chen & Peigang Wang & Rhiana Wegner & Jie Gong & Xiaoyi Fang & Linda Kaljee, 2015. "Measuring Social Capital Investment: Scale Development and Examination of Links to Social Capital and Perceived Stress," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 120(3), pages 669-687, February.
    16. Damiano Fiorillo & Nunzia Nappo, 2017. "Formal volunteering and self-perceived health. Causal evidence from the UK-SILC," Review of Social Economy, Taylor & Francis Journals, vol. 75(2), pages 112-138, April.
    17. Nrupen A Bhavsar & Manish Kumar & Laura Richman, 2020. "Defining gentrification for epidemiologic research: A systematic review," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-24, May.
    18. Damiano, Fiorillo & Fabio, Sabatini, 2011. "Quality and quantity: the role of social interactions in individual health," MPRA Paper 29777, University Library of Munich, Germany.
    19. Mohan, John & Twigg, Liz & Barnard, Steve & Jones, Kelvyn, 2005. "Social capital, geography and health: a small-area analysis for England," Social Science & Medicine, Elsevier, vol. 60(6), pages 1267-1283, March.
    20. Hswen, Yulin & Qin, Qiuyuan & Williams, David R. & Viswanath, K. & Brownstein, John S. & Subramanian, S.V., 2020. "The relationship between Jim Crow laws and social capital from 1997–2014: A 3-level multilevel hierarchical analysis across time, county and state," Social Science & Medicine, Elsevier, vol. 262(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0002232. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.