Social Frailty in Older Thai Outpatients: Prevalence, Associated Factors and 6-Month Outcomes

Social frailty (SF) is a state characterised by deficient social resources and capacities to fulfil basic social needs, and it predicts adverse health outcomes. This study aimed to determine SF prevalence among older Thai adults and identify associated and predictive factors over 6 months in outpatient settings.

This prospective cohort study enrolled 182 individuals aged ≥ 60 years without cognitive impairment attending multidisciplinary outpatient clinics from June to August 2024. SF was assessed using the Makizako Social Frailty Index, categorising participants as socially frail, prefrail, or robust. Sociodemographic, clinical, physical frailty, daily activity, quality-of-life, nutritional and depression data were collected via interviews and medical records at baseline and by telephone at follow-up. Descriptive statistics and multinomial logistic regression were used for analysis.

Participants had a mean age of 71.5 (SD 6.6) years, and 60% were female. SF prevalence was 42.3%, prefrailty 35.2% and robust status 22.5%. Most participants had primary education, lived with others and were independent in daily activities. SF was associated with older age, female sex, healthcare scheme type, physical frailty and poorer quality of life. At the 6-month follow-up, SF was associated with higher rates of hospital admission (10.9%), instrumental activities of daily living dependence (6.8%), malnutrition (11.4%) and depression (8.5%).

SF is prevalent among older outpatients and associated with age, sex, physical health, quality of life and lower-subsidy healthcare schemes. It predicts increased risks of hospitalisation, functional dependence, malnutrition and depression over 6 months. Interventions targeting SF reversal may improve health outcomes, particularly among vulnerable groups.