TOPLINE:

Among older adults, changes in frailty components were linked to changes in hospital admission. Those who had stable or improved social support or economic conditions had a lower risk for hospitalisation than those who had worsened conditions.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using data from a community-based proactive monitoring initiative from 2016 to 2024 to assess the effect of biopsychosocial frailty on rates of hospitalisation among community-dwelling older adults.
• Participants included 6086 adults aged 75 years or older (mean age, 83.6 years; 65.9% women) enrolled after more than two assessments who were followed up for an average duration of 4.8 years.
• Frailty was categorised on the basis of total scores from the assessment as robust, prefrail, frail, and very frail; trajectories were labelled as improved, stable, or worsened between the first and last assessments.
• Changes in living arrangements, informal support, social relationships, and financial conditions were examined; psycho-physical status was aggregated.
• Outcome measures captured acute hospitalisations, and mean hospitalisation rates were compared across defined frailty levels and socioeconomic items.

TAKEAWAY:

• Across 28,133 person-years, approximately 26% were hospitalised at least once, and about half of those admitted experiencing multiple admissions.
• Hospital admission rates scaled with the level of biopsychosocial frailty: 94‰, 110‰, 175‰, and 157‰ for those who were classified as robust, prefrail, frail, and very frail, respectively (P < .001).
• In the multivariable analysis, improved or stable vs worsened financial conditions were associated with a reduced risk for hospitalisation (rate ratio [RR], 0.240; 95% CI, 0.175-0.330 and RR, 0.415; 95% CI, 0.323-0.534, respectively).
• Compared with being permanently unsupported, being permanently supported (RR, 0.467; 95% CI, 0.374-0.583), support compromised (RR, 0.453; 95% CI, 0.339-0.605), or having the support restored (RR, 0.529; 95% CI, 0.409-0.685) was associated with a reduced risk for hospitalisation.

IN PRACTICE:

"[The study] finding suggests that maintaining or improving socio-economic conditions may be associated with reduced hospitalization risk, independent of physical frailty status," the authors wrote. "The study findings point out the potential of community-based interventions in reducing hospital admissions among older adults by addressing biopsychosocial frailty," they added.

SOURCE:

This study was led by Paola Scarcella, Human Sciences Department, LUMSA University, Rome, Italy. It was published online on February 16, 2026, in the European Journal of Public Health.

LIMITATIONS:

Analyses did not account for intermediate frailty states, the time spent in each frailty state, or intervening events. Clinical details underlying hospital admissions were unavailable. Key confounding factors such as multimorbidity burden, baseline function, cognition, and programme engagement levels were not adjusted.

DISCLOSURES:

No specific funding supported the work; one author reported holding a PhD scholarship and another holding a postgraduate scholarship. No relevant conflicts of interest were disclosed by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.