Assessing Social Interaction and Loneliness and Their Association With Frailty Among Older Adults With Subjective Cognitive Decline or Mild Cognitive Impairment: Ecological Momentary Assessment Approach
BackgroundFrail older adults are at greater risk of adverse health-related outcomes such as falls, disability, and mortality. Mild behavioral impairment (MBI), which is characterized by neurobehavioral symptoms in individuals without dementia, is a crucial factor in identifyi...
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JMIR Publications
2025-04-01
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| Series: | JMIR mHealth and uHealth |
| Online Access: | https://mhealth.jmir.org/2025/1/e64853 |
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| author | Bada Kang Dahye Hong Seolah Yoon Chaeeun Kang Jennifer Ivy Kim |
| author_facet | Bada Kang Dahye Hong Seolah Yoon Chaeeun Kang Jennifer Ivy Kim |
| author_sort | Bada Kang |
| collection | DOAJ |
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BackgroundFrail older adults are at greater risk of adverse health-related outcomes such as falls, disability, and mortality. Mild behavioral impairment (MBI), which is characterized by neurobehavioral symptoms in individuals without dementia, is a crucial factor in identifying at-risk groups and implementing early interventions for frail older adults. However, the specific role of social functioning, which encompasses social interaction and loneliness levels, in relation to frailty within this group remains unclear.
ObjectiveThis study investigated the association between frailty status, social interaction frequency, and loneliness levels among older adults with subjective cognitive decline (SCD) or mild cognitive impairment (MCI) while adjusting for MBI symptoms in 2 contexts: the presence and severity of MBI symptoms.
MethodsOlder adults with SCD or MCI were recruited from an outpatient clinic specializing in the early diagnosis and care management of dementia at a community health center, as well as from a community service center in Seoul, South Korea. Using an ecological momentary assessment approach, participants reported their daily social interaction frequency and loneliness level via a mobile app, 4 times daily for 2 weeks. Frailty status, the outcome variable, was assessed using the Korean version of the frailty phenotype questionnaire. Additionally, MBI symptoms were assessed using the 34-item MBI-Checklist covering 5 domains. Multinomial logistic regression analyses were performed to investigate the association between frailty status (robust, prefrail, and frail), and the independent variables, adjusting for the presence or severity of MBI symptoms.
ResultsAmong the 101 participants analyzed, 29.7% (n=30) of participants were classified as prefrail, and 12.8% (n=13) of participants were classified as frail. Higher average daily social interaction scores were consistently associated with lower odds of a frail status compared to a robust status. This was evident in the models adjusted for both the global presence (relative risk ratio [RRR] 0.18, P=.02) and global severity (RRR 0.20, P=.02) of MBI symptoms.
ConclusionsFrequent social interaction was inversely associated with frail status in older adults with SCD or MCI, even after adjusting for the presence and severity of MBI symptoms. These findings highlight the potential of social functioning as a modifiable factor for addressing frailty among older adults at risk of cognitive and functional decline. Future prospective studies using real-time measurements are needed to refine these findings and further investigate additional risk factors and functional outcomes in this group. |
| format | Article |
| id | doaj-art-78c9b68a63c84f4bbae3bf88f4fbdc5a |
| institution | DOAJ |
| issn | 2291-5222 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | JMIR Publications |
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| series | JMIR mHealth and uHealth |
| spelling | doaj-art-78c9b68a63c84f4bbae3bf88f4fbdc5a2025-08-20T03:14:49ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222025-04-0113e6485310.2196/64853Assessing Social Interaction and Loneliness and Their Association With Frailty Among Older Adults With Subjective Cognitive Decline or Mild Cognitive Impairment: Ecological Momentary Assessment ApproachBada Kanghttps://orcid.org/0000-0002-7002-2315Dahye Honghttps://orcid.org/0009-0002-6054-773XSeolah Yoonhttps://orcid.org/0009-0007-9048-0077Chaeeun Kanghttps://orcid.org/0009-0007-4504-0953Jennifer Ivy Kimhttps://orcid.org/0000-0003-1845-2200 BackgroundFrail older adults are at greater risk of adverse health-related outcomes such as falls, disability, and mortality. Mild behavioral impairment (MBI), which is characterized by neurobehavioral symptoms in individuals without dementia, is a crucial factor in identifying at-risk groups and implementing early interventions for frail older adults. However, the specific role of social functioning, which encompasses social interaction and loneliness levels, in relation to frailty within this group remains unclear. ObjectiveThis study investigated the association between frailty status, social interaction frequency, and loneliness levels among older adults with subjective cognitive decline (SCD) or mild cognitive impairment (MCI) while adjusting for MBI symptoms in 2 contexts: the presence and severity of MBI symptoms. MethodsOlder adults with SCD or MCI were recruited from an outpatient clinic specializing in the early diagnosis and care management of dementia at a community health center, as well as from a community service center in Seoul, South Korea. Using an ecological momentary assessment approach, participants reported their daily social interaction frequency and loneliness level via a mobile app, 4 times daily for 2 weeks. Frailty status, the outcome variable, was assessed using the Korean version of the frailty phenotype questionnaire. Additionally, MBI symptoms were assessed using the 34-item MBI-Checklist covering 5 domains. Multinomial logistic regression analyses were performed to investigate the association between frailty status (robust, prefrail, and frail), and the independent variables, adjusting for the presence or severity of MBI symptoms. ResultsAmong the 101 participants analyzed, 29.7% (n=30) of participants were classified as prefrail, and 12.8% (n=13) of participants were classified as frail. Higher average daily social interaction scores were consistently associated with lower odds of a frail status compared to a robust status. This was evident in the models adjusted for both the global presence (relative risk ratio [RRR] 0.18, P=.02) and global severity (RRR 0.20, P=.02) of MBI symptoms. ConclusionsFrequent social interaction was inversely associated with frail status in older adults with SCD or MCI, even after adjusting for the presence and severity of MBI symptoms. These findings highlight the potential of social functioning as a modifiable factor for addressing frailty among older adults at risk of cognitive and functional decline. Future prospective studies using real-time measurements are needed to refine these findings and further investigate additional risk factors and functional outcomes in this group.https://mhealth.jmir.org/2025/1/e64853 |
| spellingShingle | Bada Kang Dahye Hong Seolah Yoon Chaeeun Kang Jennifer Ivy Kim Assessing Social Interaction and Loneliness and Their Association With Frailty Among Older Adults With Subjective Cognitive Decline or Mild Cognitive Impairment: Ecological Momentary Assessment Approach JMIR mHealth and uHealth |
| title | Assessing Social Interaction and Loneliness and Their Association With Frailty Among Older Adults With Subjective Cognitive Decline or Mild Cognitive Impairment: Ecological Momentary Assessment Approach |
| title_full | Assessing Social Interaction and Loneliness and Their Association With Frailty Among Older Adults With Subjective Cognitive Decline or Mild Cognitive Impairment: Ecological Momentary Assessment Approach |
| title_fullStr | Assessing Social Interaction and Loneliness and Their Association With Frailty Among Older Adults With Subjective Cognitive Decline or Mild Cognitive Impairment: Ecological Momentary Assessment Approach |
| title_full_unstemmed | Assessing Social Interaction and Loneliness and Their Association With Frailty Among Older Adults With Subjective Cognitive Decline or Mild Cognitive Impairment: Ecological Momentary Assessment Approach |
| title_short | Assessing Social Interaction and Loneliness and Their Association With Frailty Among Older Adults With Subjective Cognitive Decline or Mild Cognitive Impairment: Ecological Momentary Assessment Approach |
| title_sort | assessing social interaction and loneliness and their association with frailty among older adults with subjective cognitive decline or mild cognitive impairment ecological momentary assessment approach |
| url | https://mhealth.jmir.org/2025/1/e64853 |
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