Journal of Cross-cultural Gerontology · Nov 3, 2026

Exploring the Links Between Psychosocial Factors and Frailty in Older Adults in Rural Northern Chile

By Carrasco-Díaz B, Gallardo-Peralta LP, Araya AX

Frailty is influenced by physical, health, and psychosocial vulnerabilities, yet evidence from rural older populations remains limited. This study examined the associations of sociodemographic, health, and psychosocial factors with multidimensional and physical frailty among community-dwelling older adults in a rural area of northern Chile. A cross-sectional study was conducted with 120 older adults registered at a local Family Health Centre. Multidimensional frailty was assessed using the Tilburg Frailty Indicator (TFI) and physical frailty using the Fried phenotype. Hierarchical logistic regression models examined sociodemographic and health characteristics, followed by loneliness, social network score, and depressive symptoms. Firth penalised regression was used as a sensitivity analysis. Multidimensional frailty was identified in 73.3% of participants and physical frailty in 51.7%; 83.3% had multimorbidity. Loneliness and social network score showed the most consistent associations across both frailty approaches. In the final multidimensional frailty model, greater loneliness, smaller social networks, and higher depressive symptom scores were associated with greater odds of frailty. For physical frailty, older age, greater loneliness, and smaller social networks remained independently associated with frailty, whereas depressive symptoms did not improve model fit. The addition of psychosocial variables substantially improved model fit, and sensitivity analyses generally supported the main findings. Loneliness and social network characteristics were consistently associated with both multidimensional and physical frailty among older adults living in this rural setting, while age and depressive symptoms showed construct-specific patterns. These findings highlight the relevance of incorporating psychosocial vulnerability into frailty assessment in rural older populations, while recognising that territorial and social context may influence how vulnerability is experienced and addressed.

doi.org/10.1007/s10823-026-09607-7PubMed 42972180Populations