Detection of social frailty in older adults: validation and reliability of the Makizako Social Frailty Index for Turkish older adults, a cross-sectional study

Creative Commons License

Atbas C., Sayin H., Karaduman D., Sahiner Z., Hafizoglu M., Pehlivan M., ...More

BMC Geriatrics, vol.26, no.1, 2026 (SCI-Expanded, SSCI, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 26 Issue: 1
  • Publication Date: 2026
  • Doi Number: 10.1186/s12877-025-06810-y
  • Journal Name: BMC Geriatrics
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, MEDLINE, Directory of Open Access Journals
  • Keywords: Frailty, Geriatrics, Loneliness, Older adults, Social frailty
  • Hacettepe University Affiliated: Yes

Abstract

Background: Acknowledging social frailty is crucial in nations where the number of older adults is rising. This study aims to assess the validity and reliability of the Makizako Social Frailty Index among the Turkish older adult population. Methods: One hundred and seventy patients were included in the study. Older adults admitted to the geriatric medicine outpatient clinic at the university hospital were included. All patients had a comprehensive geriatric assessment. The Edmonton Frail Scale (EFS) concordance test was used to assess the validity of the Makizako Social Frailty Index. Test-retest and inter-rater reliability analyses were also performed. Results: The mean age of the participants was 72.8 ± 5.82 years. Among them, 105 individuals (61.8%) were female. A total of 32 participants (18.8%) were living alone. There were 102 individuals (60.0%) with an educational duration of 5 years or less. There was a moderate concordance between the Makizako Social Frailty Index and the EFS (Cohen's kappa: 0.287, p<0.001). The Makizako Social Frailty Index inter-rater and retest reliabilities were excellent (Cohen's kappa: 0.913, p<0.001 and 0.895, p<0.001, respectively). The sensitivity of the Makizako Social Frailty Index determined according to the EFS was 68.00% (95%CI: 46.50-85.05), the specificity was 74.48% (95%CI: 66.58-81.35), the positive predictive value was 31.48% (95%CI: 23.78-40.35), and the negative predictive value was 93.10% (95%CI: 88.32-96.02). Conclusions: The Makizako Social Frailty Index, which comprehensively assessed social frailty through five items, was a valid and reliable tool for the Turkish older adult population.