Social Isolation and Geriatric Syndromes: Cross-Sectional Associations and the Mediating Role of Sarcopenia in Frailty

Background: Given the fast aging of the Saudi population and the growing burden of geriatric syndromes, this study explored the associations between social isolation, sarcopenia, and frailty among community-dwelling older persons in Saudi Arabia. Methods: A cross-sectional design study was conducted in the Riyadh region between February and May 2024. The diagnosis of sarcopenia utilized the Asian Working Group on Sarcopenia (AWGS) criteria. The Arabic version of the Tilburg frailty index was used to assess frailty. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for social isolation, sarcopenia, and frailty were estimated using multivariate logistic regression. Path analysis was employed to examine the direct relationships among social isolation, sarcopenia, and frailty, with standardized path coefficients (β) reported. Results: Social isolation was strongly associated with increased odds of frailty. Socially isolated participants had a nearly 6-fold higher odds of belonging to a more advanced frailty group than those who were not socially isolated (OR = 5.8; 95% CI: 1.5–21.5; p < 0.001). SEM showed that social isolation was significantly associated with frailty, both directly and indirectly, through sarcopenia. Conclusions: Our findings demonstrate an association between social isolation and frailty in older adults. Further investigation of this association may have additional clinical implications.