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Research Highlights

Social factors may predict mortality risk for older adults

A new risk prediction tool based on social characteristics may forecast four-year mortality risk for older adults. The 10-question survey, called the Social Frailty Index, improves upon existing risk models. Findings from the NIA-funded study were published in The Proceedings of the National Academy of Sciences.

Holding hands to mouth, a woman looks pensive

Social factors have been shown to predict age-related health outcomes, but there is currently no accurate measure of these attributes that can assess an individual’s future health. The challenge lies in determining which specific social factors should be included in such an assessment or model.

Researchers from Massachusetts General Hospital; Harvard Medical School; and the University of California, San Francisco analyzed data from a nationally representative sample of 8,250 adults aged over 65 enrolled in the Health and Retirement Study. They identified 183 social characteristic predictors related to social frailty, or inability to meet social needs. A statistical analysis found that eight of the 183 predictors increased the risk of death within four years: poor neighborhood cleanliness, low perceived control over financial situation, meeting with children less than yearly, not working for pay, not being active with children, not volunteering, feeling isolated, and being treated with less courtesy or respect.

Along with age and gender, these eight social predictors became part of the Social Frailty Index. The model showed that its predictions about who would die matched very closely with real life outcomes. This model was even more accurate than two commonly used models that consider multiple chronic conditions and functional abilities. Besides predicting the risk of death, the new model was also good at determining who might become disabled or need to reside in a nursing home.

The findings of this study suggest the 10-item Social Frailty Index could complement traditional prediction models, with applications in clinical, population health, and research settings. The authors note that while the risk factors identified in this model are associated with death, addressing them will not necessarily reduce mortality risk. To gain an understanding of the causal relationship between social factors and mortality risk, randomized clinical trials are needed.

This research was supported in part by NIA grants R03AG060090 and P30AG044281.

Reference: Shah SJ, et al. Social Frailty Index: Development and validation of an index of social attributes predictive of mortality in older adults. Proceedings of the National Academy of Sciences of the United States of America. 2023;120(7):e2209414120. doi: 10.1073/pnas.2209414120.

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