Development and Validation of a Social Frailty Index Among Older Adults in the Philippines

BackgroundSocial frailty has not been studied in the Philippines, a Southeast Asian country with distinct sociocultural characteristics.ObjectiveTo (i) develop and validate the Social Frailty Index-Philippines (SFI-Phil), using all-cause mortality (up to 4 years) as the outcome and (ii) evaluate performance of SFI-Phil across age, sex, and residence.MethodsPerforming regression analyses on baseline and 4-year follow-up data from 5153 older adults aged 60+ from the nationally representative Longitudinal Study of Ageing and Health in the Philippines (LSAHP), we selected and validated a parsimonious model of social predictors.ResultsThe resulting 6-item SFI-Phil demonstrated satisfactory accuracy in predicting mortality up to 4 years (C-statistic 0.640, 95% confidence interval [CI]: 0.608-0.673) in a validation sample and across demographic strata, although better amongst 60-69 year olds, men, and urban residents.ConclusionSFI-Phil, developed considering Philippines's sociocultural context, can be used to assess social frailty among older adults in the Philippines.