Association between social frailty and problematic alcohol use among middle-aged and older adults: findings from a longitudinal study in South Korea

Abstract

Background: Social frailty (SF) has emerged as an important health determinant among older adults. However, evidence of its association with problematic alcohol use (PAU) is scarce. Therefore, this study analyzed the association between SF and subsequent PAU in middle-aged and older adults in South Korea. Methods: A nationwide sample consisting of 11,174 adults >= 45 years was analyzed. SF was measured using five key domains: social support, social network, social activity, loneliness, and living alone. SF scores ranged from 0 to 5 and were categorized as robust (0), pre-SF (1), or SF (2-5). PAU was measured using the CAGE questionnaire. The association between SF exposure and PAU at 2 years of follow-up was examined using the lagged generalized estimating equation models. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: The proportions of robust, pre-SF, and SF were 53.4%, 27.2%, and 19.0%, respectively. Compared to the robust group, the adjusted OR (95% CI) for subsequent PAU was 1.09 (0.84-1.41) for pre-SF and 1.61 (1.17-2.21) for SF, respectively. When using the continuous value, SF scores were positively associated with the odds of experiencing subsequent PAU (adjusted OR: 1.21, 95% CI: 1.06-1.37). For each CAGE component, SF was associated with feeling guilty about drinking (OR: 1.39, 95% CI: 1.01-1.92) and needing to drink in the morning (OR: 1.70, 95% CI: 1.12-2.58) at the 2-year follow-up. Conclusion: This study found that exposure to SF is linked to subsequent PAU in middle-aged or older adults.