Associations of frailty, loneliness and the quality of life of empty nesters: A cross-sectional study in rural areas

Aims To explore loneliness, in association with frailty, in explaining the quality of life (QOL) of empty-nest older adults in rural China. Design A cross-sectional questionnaire survey was conducted. Methods Data collection was performed from June to August 2017 in Changchun, the capital city of Jilin province, which consists of seven districts and three counties. In total, 304 older adults aged 60 years and above participated. The characteristics of older adults were evaluated in terms of frailty status, loneliness and the QOL. One-way and two-way analyses of covariance and the area under the receiver operating characteristic curves were used to explore the relationships of frailty, loneliness and the QOL. Results The one-way ANCOVA showed a significant difference among robust, prefrail and frail participants for loneliness. Moreover, an interaction effect of frailty with loneliness in determining the QOL was found. The receiver operating characteristic curves showed that loneliness and QOL could distinguish frail older adults, and the best cutoffs were 34.5 and 67.4, respectively. Conclusion This study demonstrates a close relationship between frailty and loneliness, suggesting the need to simultaneously consider the two with regard to the QOL of empty-nest older adults in rural China. Summary statement What is already known about this topic? There were no studies examining the associations of frailty and loneliness with QOL or the cut-point of the loneliness and QOL scores to reflect frailty. Few studies have revealed an association between loneliness and frailty. These studies focus mainly on older adults living in the community, and none consider the relationship between mental status and the frailty of empty nesters. What this paper adds? This study determined that frailty, loneliness and the QOL had a close relationship in empty nesters. There was a significant interaction among frailty, loneliness and the quality of life. Loneliness and the QOL could distinguish frail older adults, and the best cutoffs were 34.5 and 67.4, respectively. The implications of this paper? This study can enable governments and communities to pay attention to the psychological status of empty-nest individuals while paying attention to their psychological problems, such as loneliness, to help them improve their quality of life.