Social vulnerability of different dimensions and physical frailty in older Chinese adults: a national cross-sectional study

Abstract

Backgroud Frailty is a significant public health concern among the elderly, with social frailty closely linked to the development and progression of physical frailty. This study examines the current status and influencing factors of social frailty among older adults in China, and explores the impact of different dimensions of social frailty on the degree of physical frailty to provide insights for delaying physical frailty. Methods Data were sourced from the Fourth Sample Survey of the Aged Population in Urban and Rural China by the China National Committee on Aging. Physical frailty was assessed using a frailty index model, and principal component analysis determined the dimensions of social frailty. Multifactorial linear regression and logistic regression analyses were conducted to examine the relationships between various dimensions of social frailty and frailty, as well as their impacts on the degree of frailty. Results A total of 12,788 older adults were included in the analysis. The frailty index (FI) value was 0.14 ± 0.10, showing an exponential increase with age, and at any age, females had higher FI values than males. Principal component analysis revealed that social frailty in the elderly primarily encompasses dimensions of living conditions, social support, social participation, economic status, and living environment. Multivariate linear regression results indicated that older adults with higher degrees of frailty are more vulnerable in terms of social support, social participation, economic status, and living environment (r = 0.095, 0.198, 0.226, 0.199, all P = 0.000), while the association with living conditions was not statistically significant. Multifactorial logistic regression analysis showed that apart from the living conditions dimension, social support, social participation, economic status, and living environment are associated with an increased risk of frailty, with economic status having the most significant impact, followed by living environment, social support, or social participation. Conclusions Social frailty is common among the elderly, and there is a reciprocal and promotive interaction between social and physical frailty. The impacts of different dimensions of social frailty on frailty vary, suggesting that targeted interventions should be developed to address various dimensions of social frailty to mitigate its effects on the frailty of older adults.