The Relationship between Physical Frailty and Life Satisfaction of the Older Adults: Role of Participation in Social Activity

Background/Purpose: Older adults are often reliant on informal social relationships to obtain resources, and the lack of socioeconomic resources caused by the disconnection during the pandemic of COVID-19 could have led to a reduction in their quality of life. Life satisfaction according to subjective perception is one of the factors determining the quality of life in these diverse environments. Therefore, it is considered significant to grasp what factors can affect the life satisfaction of older adults and to evaluate the meaning of life satisfaction to better understand the issues surrounding the aging population. Increasing the life satisfaction of older adults involves dealing with physical, mental, and social issues, and one of the efforts is to prevent physical frailty. Therefore, the purpose of this study is to examine the effect of physical frailty on life satisfaction, as well as social activity participation as a mediator among the aging population in Korea.

Methods: Data and samples: For analysis, the Korean Living Profiles of Older People Survey of 9,541 people aged 65 and over in 2020 were used (Mean age=73.32±6.44, 59.9% female). For analysis, PROCESS Macro for SPSS version 4.0 Model 4 was used to analyze the role of social activities.

Measures: Physical frailty was assessed using the Study of Osteoporotic Fracture (SOF) criteria:

unintentional weight loss of over 11 pounds in the past 6 months, exhaustion, and 5 times sit-ups from a chair or bed without using hands. The score ranges from 0 to 3, with each component worth 1 point. Frailty status was measured at 0 as robust, 1 as pre-frail, and 2 or more as frail. Out of 7 satisfaction items (health status, economic status, relationship with spouse, relationship with children, social/leisure/cultural activities, friends, and community relationships, life in general), each item (range: 0 to 5), and the sum of the 7 satisfaction (range: 0 to 35) was used. Participation in social activities was categorized into 0 to 6 across six types of activities (volunteering, learning, religion, club activities, social gathering, and political groups).

Results: The prevalence of frailty in the population was 13.9 percent (n=1,329), while the robust population was 46.0 percent (n=4,387) (p<.001). The results showed that physical frailty negatively associated not only participation in social activities (p<.001), but also life satisfaction (p<.001) of older adults. The result of verifying the indirect effect through bootstrap, the mediating effect coefficient was -.0328 (95% Confidence Interval [CI]= -.0513 ~ -.0167). Therefore, participation in social activities plays a significant indirect mediating role between physical frailty and life satisfaction.

Conclusions and Implications: Frailty is a dynamic transition from normal aging to pre-frailty to frailty and complications. Therefore, it is of great importance to prevent the vicious cycle by actively changing behavior before the state of frailty and minimizing risk factors in the pre-frail stage. By suggesting the way to prevent frailty, which affects the life satisfaction of the older adults in the era of COVID-19, and to expand participation in social activities, this study is of significance for increasing life satisfaction.