[Multilevel determinants of social frailty in community-dwelling older adults in South Korea: A cross-sectional study using Korean Community Health Survey].

Purpose: This study was conducted to identify the level of social frailty and its influencing factors among community-dwelling older adults in South Korea using a multilevel approach. Methods: Secondary data on 81,898 older adults (≥65 years) were obtained from the 2023 Community Health Survey and merged with community-level data (Statistics Korea and safety indices). Data were analyzed with weighted descriptive statistics, group comparisons, and multilevel ordinal logistic regression. Results: Of the participants, 14.1% were socially frail and an additional 34.3% were at risk. In multilevel analyses, higher age, female, lower education, unemployment, and basic livelihood security were associated with increased social frailty, as were low physical activity, poor perceived environment, and depressive symptoms. Conversely, moderate alcohol use was associated with lower social frailty risk. Between-community variance in social frailty was significant, but only community level of aging showed a significant contextual effect after adjusting for individual factors. Conclusion: Social frailty in older adults is primarily influenced by individual characteristics with a modest community context effect. Targeted interventions for vulnerable individuals, including those who are older, female, low socioeconomic status, physically inactive, or experiencing depression, together with community-level efforts in highly aged areas such as improving social infrastructure and enhancing safety, are essential to reduce social frailty.