The global population is ageing rapidly, with the most dramatic increases in developing countries like Malaysia. Older people are at increased risk of multimorbidity, frailty and falls.

In this study we aimed to determine the relationship between social participation, frailty and falls in Malaysia.

This was a cross-sectional study of individuals aged 55 years and above selected from the electoral rolls of three Klang Valley parliamentary constituencies through stratified random sampling. They were invited to take part in a questionnaire and physical assessment as part of the Malaysian Elders Longitudinal Research (MELoR) study.

Fallers were individuals who had fallen in the previous year. Frailty was defined as meeting ≥3 of: low body mass index, reduced cognition, low physical activity, low hand-grip strength, and slow walking speed. Social participation was determined from employment status, social network, and community activity. Binomial logistic regression multivariant analysis was performed to identify links between the measures of social participation and falls and frailty.

The mean age of the 1383 participants was 68.5 years, with 57.1% female. Within the population, 22.9% were fallers and 9.3% were frail. Social isolation (OR= 2.119; 95% CI=1.351–3.324), and non-engagement in community activities (OR=2.548; 95% CI=1.107–5.865) were associated with increased frailty. Falls increased with social isolation (OR=1.327; 95% CI=1.004–1.754).

Previous studies have shown social participation to be linked to frailty and falls risk, and social isolation to be a predictor of falls. In this study frailty was associated with all three social participation measures and history of falls was associated with social isolation.