Development of the social frailty scale for older adults under pandemic-related social restrictions

INTRODUCTION: Social frailty, a key dimension of the multidimensional assessment of frailty, has been linked to poor health outcomes and poorer quality of life in older adults. However, definitions and measurements of social frailty vary and most do not provide assessments of reliability or validity. This study sought to identify the core components associated with social frailty and to create a reliable, valid social frailty scale. METHODS: This study adopts a psychometric approach to develop a social frailty scale for use in a community context under pandemic-related social restrictions. Systematic searching, content analysis, and a modified Delphi method were applied to develop a draft of a social frailty scale. Item-analysis, explorative factor analysis, confirmatory factor analysis, and reliability analysis were used to test scale properties. The subjects were older adults above 65 years old who live in Taiwan, and 446 people in total were interviewed to collect data. RESULTS: The results indicated that five factors (two types of social support, social participation, social networks, and loneliness) and 16 items formed a social frailty scale with appropriate reliability and validity. This study advances our understanding of core components of social frailty. DISCUSSION: The social frailty scale integrates several social frailty instruments to detect social frailty in community context.