Impact of physical, psychological, and social frailty on quality of life by sex in adults aged 65 and older: a secondary analysis of the Korean Longitudinal Study of Aging (2018~2022)

Purpose This research aimed to explore the impact of multidimensional frailty—comprising physical, psychological, and social domains—on quality of life (QoL) in adults aged 65 years and older, with an emphasis on sex differences. Methods A secondary analysis was conducted using data from the seventh to ninth waves (2018~2022) of the Korean Longitudinal Study of Aging. Frailty was operationalized using proxy indicators conceptually aligned with the physical, psychological, and social domains defined by the Tilburg Frailty Indicator. QoL was evaluated using a self-reported, single-item scale. Generalized estimating equations were used to investigate the relationships between each frailty domain and QoL by sex while controlling for pertinent covariates. Results Overall frailty significantly reduced QoL in both men (B = -7.98, p < .001) and women (B = -9.42, p < .001). Psychological frailty had the greatest negative impact on QoL in men (B = -8.51, p < .001), while physical frailty was the most detrimental in women (B = -6.88, p < .001). Social frailty had the least impact but remained statistically significant in both sexes. Conclusion These results underscore the importance of implementing a multidimensional, sex-sensitive framework for assessing and managing frailty. Nurses should conduct comprehensive frailty evaluations and implement tailored strategies to address each domain of frailty, particularly in community settings. The results also support integrating multidimensional frailty concepts into nursing education and practice to enhance QoL in aging populations.