Research Square · Oct 28, 2026
Subjective Social Connection Perception and the Longitudinal Persistence of Frailty Among Older Adults
By Wang J, Yao J, Xu L et al.
Background Frailty shows marked longitudinal persistence, with prior frailty increasing vulnerability to subsequent decline. Although social connectedness is recognized as a psychosocial resource for healthy aging, whether older adults’ subjective perception of social connection can attenuate the carry-over effect of baseline frailty remains unclear. This study examined whether subjective social connection perception (SSCP) moderates the longitudinal persistence of frailty among Chinese older adults. Methods This longitudinal study included 1,284 adults aged 65 years and older drawn from three waves (2018–2022) of the China Health and Retirement Longitudinal Study (CHARLS). Frailty was quantified using a 40-item Frailty Index, and SSCP was assessed using a validated psychosocial scale. Linear mixed-effects models with random intercepts were used to examine within-individual changes in frailty over time. To test moderation, an interaction term between baseline frailty and SSCP was included in the model, evaluating whether SSCP attenuated the carry-over of prior frailty across follow-up assessments. Marginal effects were estimated to quantify predicted annual changes in frailty across levels of SSCP.. Results Baseline frailty strongly predicted subsequent frailty ( β = 0.472, p < 0.001). SSCP had a significant protective effect ( β = −0.186, p = 0.004), and the interaction between baseline frailty and SSCP was significant ( β = −0.093, p = 0.023). Higher perceived social connectedness was associated with slower frailty progression among older adults. corresponding to a relative reduction of approximately 38.2%. Cumulative three-year frailty increases were similarly attenuated in high SSCP individuals. Subgroup analyses confirmed that the moderating effect was robust across gender, age, baseline frailty, and socioeconomic strata. Conclusions Higher perceived social connectedness was associated with slower frailty progression among older adults. These findings suggest that subjective social resources may help buffer age-related increases in frailty and should be considered in geriatric health assessment and intervention strategies.