{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:29:15Z","timestamp":1791232155303,"version":"4.1.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T00:00:00Z","timestamp":1676851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004331","name":"Johnson and Johnson","doi-asserted-by":"publisher","award":["H1312124"],"award-info":[{"award-number":["H1312124"]}],"id":[{"id":"10.13039\/100004331","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012542","name":"Sichuan Province Science and Technology Support Program","doi-asserted-by":"publisher","award":["2018FZ0046"],"award-info":[{"award-number":["2018FZ0046"]}],"id":[{"id":"10.13039\/100012542","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012542","name":"Sichuan Province Science and Technology Support Program","doi-asserted-by":"publisher","award":["2021YFS0137"],"award-info":[{"award-number":["2021YFS0137"]}],"id":[{"id":"10.13039\/100012542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Few studies have focused on the incidence and correlation of social frailty (SF) with adverse health events in Southwest China. This study aims to explore the predictive value of SF for adverse health events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 6-year prospective cohort study was employed, a total of 460 community-dwelling older adults aged 65 years and above were analyzed to provide a baseline in 2014. Participants completed two longitudinal follow-ups at 3 (2017, 426 participants involved) and 6 (2020, 359 participants involved) years later. A modified social frailty screening index was used in this study, and adverse health events such as physical frailty (PF) deterioration, disability, hospitalization, falls, and mortality were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among these participants in 2014, the median age was 71 years, 41.1% were male, and 71.1% were married or cohabiting, up to 112 (24.3%) of them were classified as SF. It was observed that aging (OR = 1.04, 95% CI = 1.00\u20131.07, <jats:italic>P<\/jats:italic> = 0.047) and having family members die in the past year (OR = 2.60, 95% CI = 0.93\u20137.25, <jats:italic>P<\/jats:italic> = 0.068) were risk factors of SF, whereas having a mate (OR = 0.40, 95% CI = 0.25\u20130.66, <jats:italic>P<\/jats:italic> = 0.000) and having family members to help with care (OR = 0.53, 95% CI = 0.26\u20131.11, <jats:italic>P<\/jats:italic> = 0.092) were protective factors of SF. The cross-sectional study demonstrated that SF was only significantly associated with disability (OR = 12.89, 95% CI = 2.67\u201362.13, <jats:italic>P<\/jats:italic> = 0.001) at wave 1. Baseline SF significantly explained the incidence of mortality at the 3-year (medium-term, OR = 4.89, 95% CI = 2.23\u201310.71, <jats:italic>P<\/jats:italic> = 0.000) and 6-year follow-ups (long-term, OR = 2.22, 95% CI = 1.15\u20134.28, <jats:italic>P<\/jats:italic> = 0.017).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SF prevalence was higher in the Chinese older population. Older adults with SF had a significantly increased incidence of mortality at the longitudinal follow-up. Consecutive comprehensive health management of SF (e.g., avoiding living alone and increasing social engagement) is urgently needed for the purposes of early prevention and multidimensional intervention in adverse health events, including disability and mortality.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1103651","type":"journal-article","created":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T07:31:04Z","timestamp":1676878264000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Incidence and predictive value of social frailty among community-dwelling older adults in Southwest China: A prospective cohort study"],"prefix":"10.3389","volume":"11","author":[{"given":"Qian-qian","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-yu","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-yan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-yu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang-shuang","family":"Nie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1111\/j.1532-5415.2012.04054.x","article-title":"Prevalence of frailty in community-dwelling older persons: A systematic review","volume":"60","author":"Collard","year":"2012","journal-title":"J Am Geriatr Soc."},{"key":"B2","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","article-title":"Frailty in elderly people","volume":"381","author":"Clegg","year":"2013","journal-title":"Lancet."},{"key":"B3","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1111\/jnu.12322","article-title":"Frailty as a risk factor for falls among community dwelling people: Evidence from a meta-analysis","volume":"49","author":"Cheng","year":"2017","journal-title":"J Nurs Scholarsh."},{"key":"B4","doi-asserted-by":"publisher","first-page":"150","DOI":"10.14283\/jfa.2019.36","article-title":"Frailty and risk of falls in community-dwelling older adults living in a rural setting. The Atahualpa project","volume":"9","author":"Del Brutto","year":"2020","journal-title":"J Frailty Aging."},{"key":"B5","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1519\/JPT.0000000000000097","article-title":"Frailty as a predictor of nursing home placement among community-dwelling older adults: A systematic review and meta-analysis","volume":"41","author":"Kojima","year":"2018","journal-title":"J Geriatr Phys Ther."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1897","DOI":"10.1080\/09638288.2016.1212282","article-title":"Frailty as a predictor of disabilities among community-dwelling older people: A systematic review and meta-analysis","volume":"39","author":"Kojima","year":"2017","journal-title":"Disabil Rehabil."},{"key":"B7","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1093\/ageing\/afx162","article-title":"Frailty index as a predictor of mortality: A systematic review and meta-analysis","volume":"47","author":"Kojima","year":"2018","journal-title":"Age Ageing."},{"key":"B8","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1093\/ageing\/afi146","article-title":"What would make a definition of frailty successful?","volume":"34","author":"Rockwood","year":"2005","journal-title":"Age Ageing."},{"key":"B9","doi-asserted-by":"publisher","first-page":"30490","DOI":"10.3390\/ijerph15030490","article-title":"Social frailty leads to the development of physical frailty among physically non-frail adults: A four-year follow-up longitudinal cohort study","volume":"15","author":"Makizako","year":"2018","journal-title":"Int J Environ Res Public Health"},{"key":"B10","first-page":"16","article-title":"The intersection of physical and social frailty in older adults","volume":"104","author":"Quach","year":"2021","journal-title":"R I Med J."},{"key":"B11","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1016\/j.jamda.2017.02.004","article-title":"Association of social frailty with both cognitive and physical deficits among older people","volume":"18","author":"Tsutsumimoto","year":"2017","journal-title":"J Am Med Dir Assoc."},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2015.08.023","article-title":"Social frailty in community-dwelling older adults as a risk factor for disability","author":"Makizako","year":"2015","journal-title":"J Am Med Dir Assoc"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2017.04.015","article-title":"Social frailty and functional disability: Findings from the Singapore longitudinal ageing studies","author":"Teo","year":"2017","journal-title":"J Am Med Dir Assoc"},{"key":"B14","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1186\/s12877-019-1367-9","article-title":"A bio-psycho-social approach for frailty amongst Singaporean Chinese community-dwelling older adults\u2014Evidence from the Singapore Longitudinal Aging Study","volume":"19","author":"Teo","year":"2019","journal-title":"BMC Geriatr."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1016\/j.jamda.2018.09.013","article-title":"Social frailty predicts incident disability and mortality among community-dwelling Japanese older adults","volume":"19","author":"Yamada","year":"2018","journal-title":"J Am Med Dir Assoc."},{"key":"B16","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1007\/s12603-018-1054-0","article-title":"Social frailty is associated with physical functioning, cognition, and depression, and predicts mortality","volume":"22","author":"Ma","year":"2018","journal-title":"J Nutr Health Aging."},{"key":"B17","doi-asserted-by":"publisher","first-page":"104515","DOI":"10.1016\/j.archger.2021.104515","article-title":"Social frailty dimensions and frailty models over time","volume":"97","author":"Bessa","year":"2021","journal-title":"Arch Gerontol Geriatr."},{"key":"B18","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1007\/s12603-012-0084-2","article-title":"A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans","volume":"16","author":"Morley","year":"2012","journal-title":"J Nutr Health Aging."},{"key":"B19","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1093\/ageing\/afv016","article-title":"Social vulnerability and survival across levels of frailty in the Honolulu-Asia Aging Study","volume":"44","author":"Armstrong","year":"2015","journal-title":"Age Ageing."},{"key":"B20","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1186\/s12877-020-01814-2","article-title":"Physical frailty predicts the development of social frailty: A prospective cohort study","volume":"20","author":"Nagai","year":"2020","journal-title":"BMC Geriatr."},{"key":"B21","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1007\/s10433-017-0414-7","article-title":"Social frailty in older adults: A scoping review","volume":"14","author":"Bunt","year":"2017","journal-title":"Eur J Ageing."},{"key":"B22","doi-asserted-by":"publisher","first-page":"774268","DOI":"10.3389\/fnagi.2021.774268","article-title":"Transitions in the cognitive frailty states in community-living older adults: A 6-year prospective cohort study","volume":"13","author":"Tang","year":"2021","journal-title":"Front Aging Neurosci."},{"key":"B23","doi-asserted-by":"publisher","first-page":"3","DOI":"10.4235\/agmr.2018.22.1.3","article-title":"Social frailty among community-dwelling older adults: Recommended assessments and implications","volume":"22","author":"Makizako","year":"2018","journal-title":"Ann Geriatr Med Res."},{"key":"B24","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.jamda.2013.12.002","article-title":"Transitions in frailty states among community-living older adults and their associated factors","volume":"15","author":"Lee","year":"2014","journal-title":"J Am Med Dir Assoc."},{"key":"B25","doi-asserted-by":"publisher","first-page":"873","DOI":"10.2147\/CIA.S130794","article-title":"Effects of multi-domain interventions in (pre)frail elderly on frailty, functional, and cognitive status: A systematic review","volume":"12","author":"Dedeyne","year":"2017","journal-title":"Clin Interv Aging."},{"key":"B26","doi-asserted-by":"publisher","first-page":"124239","DOI":"10.3390\/ijerph17124239","article-title":"Social frailty is independently associated with mood, nutrition, physical performance, and physical activity: Insights from a theory-guided approach","volume":"17","author":"Pek","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"B27","doi-asserted-by":"publisher","first-page":"13","DOI":"10.14283\/jfa.2012.3","article-title":"How to include the social factor for determining frailty?","volume":"1","author":"Gutierrez-Robledo","year":"2012","journal-title":"J Frailty Aging."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.1093\/gerona\/glx225","article-title":"Oral frailty as a risk factor for physical frailty and mortality in community-dwelling elderly","volume":"73","author":"Tanaka","year":"2018","journal-title":"J Gerontol A Biol Sci Med Sci."},{"key":"B29","doi-asserted-by":"publisher","first-page":"104105","DOI":"10.1016\/j.archger.2020.104105","article-title":"Association between oral, social, and physical frailty in community-dwelling older adults","volume":"89","author":"Hironaka","year":"2020","journal-title":"Arch Gerontol Geriatr."},{"key":"B30","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/j.gerinurse.2015.08.006","article-title":"Summary of factors contributing to falls in older adults and nursing implications","volume":"36","author":"Enderlin","year":"2015","journal-title":"Geriatr Nurs."},{"key":"B31","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1097\/MLR.0000000000001150","article-title":"Insurance loss in the era of the affordable care act: Association with access to health services","volume":"57","author":"Mojtabai","year":"2019","journal-title":"Med Care."},{"key":"B32","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1007\/s00391-020-01693-7","article-title":"Disability and age-observations from an intersectional perspective","volume":"53","author":"Denninger","year":"2020","journal-title":"Z Gerontol Geriatr."},{"key":"B33","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.sleh.2020.10.002","article-title":"Poor sleep quality and physical performance in older adults","volume":"7","author":"Denison","year":"2021","journal-title":"Sleep Health."},{"key":"B34","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1177\/0164027517741347","article-title":"Disorderly households, self-presentation, and mortality: Evidence from a national study of older adults","volume":"40","author":"Schafer","year":"2018","journal-title":"Res Aging."},{"key":"B35","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.archger.2018.02.013","article-title":"Predictive validity of the Brazilian version of the Tilburg Frailty Indicator for adverse health outcomes in older adults","volume":"76","author":"Santiago","year":"2018","journal-title":"Arch Gerontol Geriatr."},{"key":"B36","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1155\/2014\/256519","article-title":"Reducing fall risk in the elderly: Risk factors and fall prevention, a systematic review","volume":"105","author":"Pfortmueller","year":"2014","journal-title":"Minerva Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/j.jamda.2015.06.018","article-title":"Frailty as a predictor of future falls among community-dwelling older people: A systematic review and meta-analysis","volume":"16","author":"Kojima","year":"2015","journal-title":"J Am Med Dir Assoc."},{"key":"B38","doi-asserted-by":"publisher","first-page":"265","DOI":"10.2147\/CIA.S243233","article-title":"The Tilburg Frailty Indicator (TFI): New evidence for its validity","volume":"15","author":"Gobbens","year":"2020","journal-title":"Clin Interv Aging."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1103651\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T07:31:08Z","timestamp":1676878268000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1103651\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,20]]},"references-count":38,"alternative-id":["10.3389\/fpubh.2023.1103651"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1103651","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,20]]},"article-number":"1103651"}}