Prevalence and potential influencing factors of social frailty among community-dwelling older adults in China: systematic review and meta-analysis

Abstract Objective Based on the local context in China, this study systematically reviews and explores the prevalence of social frailty among community-dwelling older adults in China and its potential influencing factors. Methods A systematic search was conducted in databases including CNKI, VIP, Wanfang Data, the Chinese Biomedical Literature Database, PubMed, the Cochrane Library, Web of Science, and Embase, covering the period from the inception of each database to November 9, 2025. Two researchers independently performed the systematic literature search, data extraction, and article quality assessment. Meta-analysis was conducted using Stata 15.1 software, incorporating cross-sectional and cohort studies; a random-effects model was used to calculate the pooled prevalence of social frailty and pre-frailty; odds ratios (OR) and 95% confidence intervals (CI) were used to assess associated influencing factors; the I 2 statistic was used to assess heterogeneity, and subgroup analysis and meta-regression were performed. Results An initial search identified 5,488 articles; after screening, a total of 24 studies ( n = 242,591) were ultimately included. The random-effects model showed that the pooled prevalence of social frailty among community-dwelling older adults in China was 25.0% (95% CI: 19.4%–31.0%, I 2 = 99.47%, P < 0.001),and the prevalence of pre-social frailty was 42.0% (95% CI: 37.6%–46.3%, I 2 = 94.80%, P < 0.001). Gender (female), advanced age (≥ 85 years), depression, physical frailty, housing satisfaction, marital status, and physical frailty were significantly associated with the risk of social frailty (OR: 1.36–4.15). Conclusions Pre-social frailty and social frailty are common health challenges faced by community-dwelling older adults in China. Recent data indicate that the prevalence of these conditions remains high; although the prevalence is the very high heterogeneity and should be interpreted with caution, it nevertheless underscores the necessity and urgency of implementing effective interventions. Early identification and intervention for individuals at risk of social frailty are of critical importance for advancing the Healthy China strategy and achieving the goals of active aging. PROSPERO registration number CRD420251246136.