Abstract:

Objective To investigate the association between intrinsic capacity and social frailty in community-dwelling older adults with chronic diseases，and to provide a scientific basis for the assessment and intervention of social frailty in this population. Methods Using convenience sampling，a total of 1，098 older adults with chronic diseases were recruited from 5 communities in Lunan District，Tangshan City，between July 2024 and May 2025. Data were collected using a general information questionnaire，the Social Frailty Scale，the eHealth Literacy Scale，the Athens Insomnia Scale，and assessment tools for the 5 domains of intrinsic capacity. Inverse Probability of Treatment Weighting was employed to balance baseline characteristics. Restricted Cubic Spline analysis was used to explore the dose-response relationship between intrinsic capacity and social frailty，followed by subgroup analyzes. Results A total of 1，034 valid questionnaires were recovered. The prevalence of intrinsic capacity decline and social frailty in community-dwelling older adults with chronic diseases was 52.80% and 34.04%，respectively. Hierarchical logistic regression analysis showed that intrinsic capacity decline was an independent risk factor for social frailty（OR=2.920，P<0.001）. RCS analysis revealed a significant non-linear association between the two；the risk of social frailty increased significantly when the intrinsic capacity score was <3（OR=3.877，P<0.001）. Subgroup analysis indicated that the association between intrinsic capacity and social frailty was more pronounced in older adults who were aged >70 years，had a junior high school education or below，had ≥2 chronic diseases，possessed low eHealth literacy，or suffered from sleep disorders（P<0.05）. Conclusion A decline in intrinsic capacity significantly increases the risk of social frailty among community-dwelling older adults with chronic diseases. Healthcare professionals should prioritize the assessment of intrinsic capacity levels in older adults and implement targeted interventions to reduce the risk of social frailty.

Key words: Aged, Community Nursing, Chronic Diseases, Social Frailty, Intrinsic Capacity, Chronic Disease Care

摘要：

目的 探究内在能力与社会衰弱的关联，为社区慢性病老年人社会衰弱的评估与干预提供科学依据。 方法 采用便利抽样法，于2024年7月—2025年5月选取唐山市路南区的5个社区的1 098例慢性病老年人为调查对象。采用一般资料调查表、社会衰弱量表、电子健康素养量表、阿森斯失眠量表、内在能力五维度评估工具进行调查，采用逆概率加权法平衡基线资料，采用限制性立方样条分析内在能力和社会衰弱的剂量-反应关系，并进行亚组分析。 结果 回收有效问卷1 034份，社区慢性病老年人内在能力下降和社会衰弱检出率分别为52.80%和34.04%。分层Logistic回归显示，内在能力下降是社会衰弱的独立危险因素（OR=2.920，P<0.001）。限制性立方样条分析显示二者存在明显的非线性关联，当内在能力<3分时，社会衰弱发生风险增加（OR=3.877，P<0.001）。亚组分析表明，在年龄>70岁、初中及以下学历、患2种及以上慢性病、低水平电子健康素养及存在睡眠障碍的老年人中，内在能力和社会衰弱关联更为显著（P<0.05）。 结论 社区慢性病老年人内在能力下降会增加社会衰弱发生风险。医护人员应重视老年人内在能力水平，为其实施精准干预措施，降低社会衰弱的发生风险。

关键词: 老年人, 社区护理, 慢性病, 社会衰弱, 内在能力, 慢性病护理