Recently, the research team led by Prof. Li Xiangwei from the Global Health Institute, Shanghai Jiao Tong University School of Medicine - National Institute of Parasitic Diseases, published an online research article titled "Social frailty and its association with cognitive trajectories in older adults: a prospective cohort study" (DOI: 10.1186/s13195-025-01687-w) in the neuroscience journal "Alzheimer's Research & Therapy". The study evaluated social frailty based on multiple social factors and found that social frailtywasassociated with accelerated decline in cognitive function among older adults.
Social frailty is a multidimensional concept that encompasses various social aspects, including social behaviors (e.g., participating in club or group activities), social resources (e.g., living with spouses/partners), general resources (e.g., financial situation) and basic social needs (e.g., social support). It is defined as a progressive state of being vulnerable to the loss or deprivation of resources that are necessary to fulfill one’s basic social needs throughout life. Studies reported that social frailty affects approximately 18.8% of community-dwelling older adults and 47.3% of those in hospital settings. Epidemiological evidence shows a significant association between social frailty and increased risks of disability, depression, and mortality, highlighting its public health implications. However, the association between social frailty in older adults and the trajectory of cognitive function over time remains unclear.
Based on data from the National Health and Aging Trends Study (NHATS), the study included 4,956 older adults aged 65 and above without dementia. Social frailty status was assessed using multiple social factors. The global cognitive function and domain-specific cognitive functions (including memory, orientation, and executive function) were also evaluated. Mixed linear models were applied to explore the relationship between social frailty and cognitive trajectories. The findings revealed that social frailty accelerated the decline in global cognitive function among older adults (beta = -0.041, 95% CI: -0.047, -0.036). Additionally, social frailty was associated withanaccelerated decline in domain-specific cognitive functions, including memory (beta = -0.045, 95% CI: -0.055, -0.036), orientation (beta = -0.083, 95% CI: -0.096, -0.070), and
executive function (beta = -0.042, 95% CI: -0.053, -0.032).
The study assessed the status of social frailty based on multiple social factors and for the first time identified a significant association between social frailty and the cognitive trajectories of older adults, independent of socioeconomic status, lifestyle, chronic diseases, and mental health. These findings suggest that mitigating an individual’s social frailty (e.g., by enhancing interactions with family members, relatives, and friends) may be an effective strategy for early prevention of cognitive impairment and subsequent dementia in older adults.
Dr. Zhang Hui at Shanghai Jiao Tong University School of Medicine is the first author and corresponding author. Prof. Li Xiangwei is the last corresponding author. Prof. Wang Xiaofeng, Dr. Li Yi and Hu Zixin from Fudan University also contributed to this paper. The study was supported by the National Natural Science Foundation of China and the International Joint Laboratory on Tropical Diseases Control in Greater Mekong Subregion.
https://doi.org/10.1186/s13195-025-01687-w
