Rethinking health-care systems to tackle social isolation and frailty

Ageing populations face increasing burdens from frailty and social isolation, which are two inter-related public health challenges that increase the risk of dementia, hospitalisation, and mortality. Despite health systems' potential to intervene, the co-occurrence of frailty and social isolation remains overlooked in policy, research, and routine care, leading to fragmented and insufficient responses. Structural barriers (eg, cultural and linguistic obstacles, low health literacy, complex system navigation, financial constraints, geographical isolation, and care coordination) further limit access. In this Viewpoint, we highlight four priorities to address these challenges: (1) screening in primary and acute care; (2) integrated medical and social care; (3) social prescribing; and (4) equity-focused policy and research within ageing strategies. Coordinated and cross-sector action that addresses social determinants of health and embeds frailty prevention and social wellbeing as core health system functions is urgently needed to enable healthy ageing.