Social frailty independently predicts 9-year mortality among community-dwelling older adults in Mexico: validation of a brief social frailty index.

INTRODUCTION

Social frailty, defined as deficits in social resources, roles, and engagement, is an emerging risk dimension. However, evidence on its measurement and prognostic value in Latin America is limited.

METHODS

Using nationally representative data from the Mexican Health and Aging Study (2012-2021), we adapted a five-item Social Frailty Index (SFI) and evaluated its psychometric properties and association with 9-year all-cause mortality in 5,400 community-dwelling adults aged ≥60 years.

RESULTS

At baseline, 38.9% were pre-frail (SFI = 1) and 25.2% were frail (SFI ≥ 2). Mortality increased progressively across categories. In fully adjusted Cox models, pre-frailty (HR = 1.21, 95%CI: 1.06-1.37) and frailty (HR = 1.56, 95%CI: 1.36-1.79) independently predicted higher mortality risk.

DISCUSSION: The SFI, adapted to available MHAS data, demonstrated prognostic relevance. This provides initial evidence supporting further research on social frailty assessment in the region, including cultural adaptation and external validation.