Prevalence and determinants of social frailty among community-dwelling empty-nest older adults in China

OBJECTIVE: To investigate the prevalence of social frailty and identify associated factors among community-dwelling empty-nest elders in China. METHODS: A multistage random sampling strategy was employed to recruit 739 empty-nest older adults residing in urban communities in Changsha, China, between March and October 2023. Data were collected via structured questionnaires, including a general information form, the Social Frailty Index Scale, the Lubben Social Network Scale-6, the Family APGAR Index, UCLA Loneliness Scale - Short Form, and Geriatric Depression Scale - 5-item version. RESULTS: The mean social frailty score was 1.64 ± 1.61. Among the participants, 38.02% were categorized as prefrail, 36.54% as frail, and 25.44% as non-frail. Multivariate logistic regression analysis revealed several protective factors against social frailty, including being married and cohabiting, being married but living apart, being enrolled in urban employment or urban resident medical insurance, participating in recreational activities, and having stronger family support. Conversely, risk factors for social frailty included being aged 60-69 years, having a monthly income below ¥1,000 or between ¥1,000-2,999, having multiple chronic conditions, experiencing social isolation, displaying depressive symptoms, and reporting greater levels of loneliness. CONCLUSION: Social frailty is common among community-dwelling empty-nest older adults in China. The key influencing factors include age, marital and cohabitation status, income level, medical insurance type, recreational activity, chronic disease burden, social isolation, family support, depressive symptoms, and loneliness. These findings underscore the importance of targeted public health strategies aimed at reducing social frailty in this vulnerable population.