Prefrailty: The Relationship Between Daily Activities and Social Participation in Older Persons

Objectives: To analyze prefrailty's relationship with limitations in activities of daily living (ADLs) and restrictions in social participation. Method: Robust (Fried 0/4; n = 214; M-age = 82.3 years [SD +/- 2.1]) and prefrail (Fried 1-2/4; n = 191; M-age = 83.8 years [SD +/- 3.2]) community-dwelling older individuals were included. Frailty scores were obtained from weight loss, exhaustion, gait speed, and grip strength. A total disability index (DI) expressed dependency for basic (b-), instrumental (i-), and advanced (a-)ADLs. Total participation score, being a member, total number of memberships, being a board member, level of participation, membership over time, volunteering, and formal participation represented social participation. Results: Logistic regression retained age (OR = 1.224; 95% CI = [1.122, 1.335]), sex (OR = 3.818; 95% CI = [2.437, 5.982]), and a-ADL-DI (OR = 1.230; 95% CI = [1.018, 1.486]) as variables significantly related to prefrailty (68.3%; chi(2) = 68.25; df = 3; p < .001). Discussion: Subtle limitations in a-ADLs, higher age, and being a man were associated with prefrailty, revealing the possible role of personal and culturally related a-ADLs as red flags for (pre)frailty.