“Social frailty” has more of an impact on the onset of depression in older adults than does physical frailty or cognitive impairment, according to a study published in the June issue of JAMDA: the Journal of Post-Acute and Long-Term Care Medicine.

The authors recommend interventions to help prevent socially frail older adults from becoming depressed.

Researchers in Japan assessed 3,538 older adults for frailty status — including physical frailty, cognitive impairment and social frailty — as well as depressive symptoms.

Five questions were used to determine social frailty, and they sought to determine how often an older adult went out compared with the previous year as well as whether the older adult felt helpful to friends or family, lived alone, spoke with someone every day, and sometimes visited friends. A negative answer to one question could indicate social frailty and a negative answer to two questions could indicate fully developed social frailty.

Four years after the original assessment, participants again were assessed for symptoms of depression. The incidence rates of depressive symptoms for each frailty status: 12% for social frailty versus 5.1% without, 9.6% for physical frailty versus 4.6% without, and 9.3% for cognitive impairment versus 6.5% without.

“Taking into account the negative impacts of depressive symptoms on both older adults themselves and our society, it may be important for medical professionals to develop interventions for older adults with social frailty to prevent them from developing depressive symptoms,” the authors said.

The researchers recommended additional studies to determine whether a causal association exists between social frailty and symptoms of depression.