Social frailty and its influencing factors among elderly lung cancer patients undergoing chemotherapy
WANG Qingqing1, LIU Hong1, ZHANG Wei1, WANG Hongcai2, LI Xuhong1, WANG Yinuo1, ZHANG Yuanyuan1
1. School of Nursing, Shandong Second Medical University, Weifang, Shandong 261053, China; 2. Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong 261031, China
Abstract:Objective To investigate the current status and influencing factors of social frailty among elderly lung cancer patients undergoing chemotherapy, so as to provide evidence for developing early-screening and hierarchical-management strategies for social frailty. Methods From November 2025 to April 2026, hospitalized elderly lung cancer patients undergoing chemotherapy in the Department of Respiratory Medicine and Department of Oncology of a tertiary A hospital in Weifang City, Shandong Province were selected as study participants using convenience sampling method. Data on demographic characteristics, life behaviors, pathological staging, and number of chemotherapy cycles were collected through questionnaire surveys. Comorbidity burden, physical frailty, instrumental activities of daily living capacity, depressive symptoms, and social frailty were assessed using the Charlson Comorbidity Index, Clinical Frailty Scale, Instrumental Activities of Daily Living Scale, Patient Health Questionnaire-9, and Chinese Social Frailty Index Scale, respectively. A multivariable logistic regression model was used to analyze the influencing factors of social frailty among elderly lung cancer patients undergoing chemotherapy. Results A total of 249 elderly lung cancer patients undergoing chemotherapy were surveyed, including 192 males (77.11%) and 57 females (22.89%). The mean age of the participants was (68.86±5.83) years. Social frailty was identified in 73 participants, with a detection rate of 29.32%. Multivariable logistic regression analysis showed that junior high school education level or above (OR=0.171, 95%CI: 0.031-0.940), having a spouse (OR=0.132, 95%CI: 0.028-0.634), and higher scores of instrumental activities of daily living capacity (OR=0.360, 95%CI: 0.180-0.721) had a lower risk of social frailty; number of chemotherapy cycles ≥4 (OR=4.168, 95%CI: 1.131-15.361), higher Charlson Comorbidity Index (OR=4.749, 95%CI: 2.117-10.653), higher physical frailty scores (OR=3.274, 95%CI: 1.330-8.057), and higher depressive symptom scores (OR=2.005, 95%CI: 1.358-2.961) had a higher risk of social frailty. Conclusions The detection rate of social frailty among elderly lung cancer patients undergoing chemotherapy was relatively high. Education level, marital status, number of chemotherapy cycles, comorbidity burden, physical frailty, instrumental activities of daily living capacity and depressive symptoms were the influencing factors of social frailty among elderly patients with lung cancer undergoing chemotherapy.
王晴晴, 刘泓, 张伟, 王红彩, 李旭鸿, 王一诺, 张媛媛. 老年肺癌化疗患者社会衰弱及影响因素分析[J]. 预防医学, 2026, 38(9): 917-922.
WANG Qingqing, LIU Hong, ZHANG Wei, WANG Hongcai, LI Xuhong, WANG Yinuo, ZHANG Yuanyuan. Social frailty and its influencing factors among elderly lung cancer patients undergoing chemotherapy. Preventive Medicine, 2026, 38(9): 917-922.
[1] Xia C F,Li H,Wu C,et al.Cancer burden and control in China:landscape,trends and challenges[J].Nat Rev Clin Oncol,2026,23(9):694-711. [2] 罗钰,杨雪,王力.肺癌化疗患者认知功能障碍现状及影响因素分析[J].华西医学,2025,40(5):722-727. [3] Wang C,Qiu X K,Yang X L,et al.Factors influencing social isolation among cancer patients:a systematic review[J/OL].Healthcare (Basel),2024,12(10)[2026-08-29].https://doi.org/10.3390/healthcare12101042. [4] Bunt S,Steverink N,Olthof J,et al.Social frailty in older adults:a scoping review[J].Eur J Ageing,2017,14(3):323-334. [5] Zhang H,Hao M,Hu Z X,et al.Social frailty and its association with cognitive trajectories in older adults:a prospective cohort study[J/OL].Alzheimers Res Ther,2025,17(1)[2026-08-29].https://doi.org/10.1186/s13195-025-01687-w. [6] Yamada M,Arai H.Social frailty predicts incident disability and mortality among community-dwelling Japanese older adults[J].J Am Med Dir Assoc,2018,19(12):1099-1103. [7] Shah S J,Oreper S,Jeon S Y,et al.Social Frailty Index:development and validation of an index of social attributes predictive of mortality in older adults[J/OL].Proc Natl Acad Sci U S A,2023,120(7)[2026-08-29].https://doi.org/10.1073/pnas.2209414120. [8] Møller J K,la Cour K,Pilegaard M S,et al.Social vulnerability among cancer patients and changes in vulnerability during their trajectories-a longitudinal population-based study[J/OL].Cancer Epidemiol,2023,85[2026-08-29].https://doi.org/10.1016/j.canep.2023.102401 [9] Charlson M E,Pompei P,Ales K L,et al.A new method of classifying prognostic comorbidity in longitudinal studies:development and validation[J].J Chronic Dis,1987,40(5):373-383. [10] Rockwood K,Song X W,MacKnight C,et al.A global clinical measure of fitness and frailty in elderly people[J].CMAJ,2005,173(5):489-495. [11] Fillenbaum G G,Smyer M A.The development,validity,and reliability of the oars multidimensional functional assessment questionnaire[J].J Gerontol,1981,36(4):428-434. [12] Kroenke K,Spitzer R L,Williams J B.The PHQ-9:validity of a brief depression severity measure[J].J Gen Intern Med,2001,16(9):606-613. [13] 张露露,高静,吴晨曦,等.社会衰弱指数量表的汉化及信效度检验[J].护理学杂志,2023,38(8):102-105. [14] 于珊,车雅洁,苏比伊努尔·麦麦提,等.城乡老年人社会衰弱现状及对比研究[J].护理学杂志,2025,40(15):6-12. [15] 彭心雨,宋明方,张婉,等.社区老年人社会衰弱现状及影响因素[J].护理研究,2021,35(19):3401-3406. [16] Hegde M,Daimary U D,Girisa S,et al.Tumor cell anabolism and host tissue catabolism-energetic inefficiency during cancer cachexia[J].Exp Biol Med (Maywood),2022,247(9):713-733. [17] 贾茜茜,任树风,杨雪霞,等.基于健康社会决定因素模型的社区老年慢性疾病患者社会衰弱影响因素研究[J].中国医药导报,2026,23(10):28-33. [18] Zhang D H,Zheng W H,Li K Y.The relationship between marital status and cognitive impairment in Chinese older adults:the multiple mediating effects of social support and depression[J/OL].BMC Geriatr,2024,24(1)[2026-08-29].https://doi.org/10.1186/s12877-024-04975-6. [19] Mehrabi F,Pomeroy M L,Cudjoe T K M,et al.The temporal sequence and reciprocal relationships of frailty,social isolation and loneliness in older adults across 21 years[J/OL].Age Ageing,2024,53(10)[2026-08-29].https://doi.org/10.1093/ageing/afae215. [20] 乔丽敏,赵雅宁,刘瑶,等.老年轻型缺血性脑卒中患者社会衰弱的影响因素及护理启示[J].中华护理杂志,2025,60(10):1251-1256. [21] 袁艳玲,刘燕,王娜,等.中老年慢性病患者社会隔离与抑郁的发展轨迹及关系研究[J].护理学杂志,2026,41(1):93-97.