Social Frailty and Social Isolation in Chinese Community-Dwelling Older Adults: A Network Analysis

Background: China's rapidly ageing population faces a double burden of social frailty (SF) and social isolation (SI), both of which accelerate functional decline and increase healthcare use. Clarifying their interplay is essential for nurses, who are often the first to assess and intervene in older adults' social health. Method: In a cross-sectional study, 451 community-dwelling adults aged ≥ 60 years (median = 71) completed the HALFT Social Frailty Scale and the Social Isolation Scale for Older Adults. A mixed graphical model based on Spearman correlations mapped symptom-level associations between SF and SI and identified central nodes. Result: SF was present in 22.8% of participants, and the median SI score was 13 (IQR = 9-16). The strongest edge linked "inability to help others" (SF1) with reduced "face-to-face contact frequency" (SI1) (edge weight = 1.85). Central nodes were "lack of social participation" (SI2), "sense of belonging" (SI4), and "lack of someone to talk to" (SF5), indicating key points where SF and SI converge. Conclusions: The tight network connecting SF and SI suggests that nursing assessments should screen for both constructs simultaneously. Interventions that increase social participation, foster belonging, and create opportunities for reciprocal helping may mitigate both syndromes, supporting healthier ageing and reducing downstream healthcare utilization.