Author(s): HOU, W., JIAO, J., Institution: HONG KONG BAPTIST UNIVERSITY, Country: HONG KONG, Abstract-ID: 2185

INTRODUCTION: Frailty is recognized as a multidimensional condition involving biological, psychological, and social domains. Deficits may occur alone or in combination, resulting in heterogeneous frailty patterns, even among individuals with similar overall frailty status. The Tilburg Frailty Indicator (TFI) operationalizes these domains and has been aggregated into seven frailty deficit (FD) patterns: physical, psychological, social, and their combinations. However, frailty is often conceptualized along a physical versus non-physical axis. It remains unclear whether these patterns can be simplified based on physical status and how such FD types relate to biopsychosocial and modifiable health-related factors. Therefore, this study examines whether social-, psychological-, and physical-domain factors are associated with FD patterns in older adults.
METHODS: A cross-sectional study was conducted among community-dwelling older adults in Hong Kong (N = 336; age 68.1±4.9 years; 18.8% male). Frailty status was assessed using the 15-item TFI, and participants were classified into four FD patterns: multi- or only physical frailty (FD1), physical co-occurring with psychological or social frailty (FD2), non-physical psycho-social frailty (FD3), and health (FD4). Social factors (perceived social vulnerability, household size), psychological factors (self-efficacy), physical factors (PA, fitness functions), and nutritional status were assessed. Multinomial logistic regression models were used to examine associations with FD patterns, adjusting for age and gender. Odds ratios (95%CIs) were reported, with significance at p < 0.05.
RESULT&DISCUSSION: The distribution of FD patterns was: FD1, 113; FD2, 74; FD3, 73; and FD4, 76. Age and gender adjusted multinomial models (ref: FD4) showed the largest between-pattern differences for social factors. Higher perceived social vulnerability was associated with higher odds of FD1 (OR=2.03, p < 0.001) and FD3 (OR=1.83, p = 0.008), whereas larger household size was inversely associated with of FD2 (OR= 0.63, p = 0.009), FD3 (OR=0.67, p = 0.018). Greater lower-limb strength(30s chair stand test) was associated with lower odds of FD1 (OR=0.67, p = 0.048). Psychological variables were not independently associated with FD patterns; nutrition showed a borderline protective trend for FD1 (p = 0.068).
These findings suggest that social vulnerability serve as a stratification signal for frailty patterns, with implications for pattern-informed screening. Social vulnerability may indicate deficits in social support and resource access, contributing to frailty through stress-related pathways and reduced engagement. Living with more family members showed a protective association with psychosocial frailty, consistent with stress-buffering theory. Incorporating social vulnerability into assessment may facilitate stratified care.
FUNDINGS: General Research Fund (12600824), PROCORE-France/Hong Kong Joint Research Scheme(F-HKBU202/24).