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Rethinking health-care systems to tackle social isolation and frailty

Authors: Mehrabi FPomeroy MLHoogendijk EOCudjoe TKMOremus MBandeen-Roche KOga-Omenka C


Affiliations

1 Department of Psychology, Concordia University, Montreal, QC, Canada.
2 Center for Equity in Aging, Johns Hopkins School of Nursing, Baltimore, MD, USA.
3 Department of Epidemiology & Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam UMC, Amsterdam, Netherlands. Electronic address: e.hoogendijk@amsterdamumc.nl.
4 Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA.
5 School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada.
6 Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA.

Description

Ageing populations face increasing burdens from frailty and social isolation, which are two inter-related public health challenges that increase the risk of dementia, hospitalisation, and mortality. Despite health systems' potential to intervene, the co-occurrence of frailty and social isolation remains overlooked in policy, research, and routine care, leading to fragmented and insufficient responses. Structural barriers (eg, cultural and linguistic obstacles, low health literacy, complex system navigation, financial constraints, geographical isolation, and care coordination) further limit access. In this Viewpoint, we highlight four priorities to address these challenges: (1) screening in primary and acute care; (2) integrated medical and social care; (3) social prescribing; and (4) equity-focused policy and research within ageing strategies. Coordinated and cross-sector action that addresses social determinants of health and embeds frailty prevention and social wellbeing as core health system functions is urgently needed to enable healthy ageing.


Links

PubMed: https://pubmed.ncbi.nlm.nih.gov/41662853/

DOI: 10.1016/S2468-2667(25)00324-X