Background Loneliness is described as the subjective experience of unfulfilled personal and social needs, with emotional and social domains. Frailty is a state of vulnerability to stressors, which is often characterised by impairment in the physical, psychological and/or social domain. Objective This study aims to examine the bidirectional association between loneliness and frailty across the different domains. Methods The study included 1735 older adults from the Urban Health Centres Europe project. Loneliness was assessed using the six-item De Jong Gierveld Loneliness Scale. Frailty was assessed by the Tilburg Frailty Indicator. Multivariate linear regression and cross-lagged panel models were used to explore the associations between the social and emotional loneliness dimensions and overall, physical, psychological and social frailty. Results A bidirectional association existed between overall loneliness and overall frailty (loneliness to frailty: β = 0.09, 95% CI: 0.03, 0.15; frailty to loneliness: β = 0.05, 95% CI: 0.004, 0.10). Higher levels of overall loneliness at baseline were associated with higher levels of psychological frailty at follow-up (β = 0.05, 95% CI: 0.00, 0.10). The reverse association was not significant. A bidirectional association existed between overall loneliness and social frailty (loneliness to social frailty: β = 0.05, 95% CI: 0.01, 0.10; social frailty to loneliness: β = 0.05, 95% CI: 0.00, 0.09). Conclusion This study confirms the importance of addressing loneliness among older adults. Interventions that increase social support, exercise engagement and promote healthy behaviours may be effective in reducing the risk of frailty among older adults and simultaneously preventing loneliness.

中文翻译：

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五个欧洲国家社区老年人孤独与虚弱之间的关联：一项纵向研究


背景 孤独被描述为个人和社会需求未得到满足的主观体验，包括情感和社会领域。虚弱是一种易受压力源影响的状态，其特征通常是身体、心理和/或社会领域的损害。目的 本研究旨在检查不同领域孤独感和虚弱感之间的双向关联。方法 该研究包括来自欧洲城市健康中心的 1735 名老年人。使用六项 De Jong Gierveld 孤独量表评估孤独度。衰弱由 Tilburg Frailty Indicator 评估。使用多元线性回归和交叉滞后面板模型来探索社会和情感孤独维度与整体、身体、心理和社会脆弱性之间的关联。结果 总体孤独感与整体衰弱感之间存在双向关联 （孤独感与衰弱感：β = 0.09,95% CI：0.03,0.15;脆弱性与孤独感：β = 0.05,95% CI：0.004,0.10）。基线时较高水平的总体孤独感与随访时较高水平的心理脆弱相关 （β = 0.05,95% CI： 0.00,0.10）。反向关联不显著。总体孤独感与社会脆弱性之间存在双向关联（孤独感与社会脆弱性：β = 0.05,95% CI：0.01,0.10;社会脆弱性与孤独感：β = 0.05,95% CI：0.00,0.09）。结论 本研究证实了解决老年人孤独感的重要性。增加社会支持、锻炼参与和促进健康行为的干预措施可能有效降低老年人虚弱的风险，同时防止孤独。