Social frailty in heart failure is consistently linked to adverse outcomes such as diminished quality of life, increased rehospitalisation risk, and higher mortality.
Social frailty in heart failure lacks a unified definition and standardized measurement but is consistently associated with adverse outcomes such as diminished quality of life, increased rehospitalization, and higher mortality.
BACKGROUND: Social frailty is increasingly recognised among people living with heart failure and is linked to a range of clinical and psychosocial risk factors, with significant implications for health outcomes. However, inconsistencies in the conceptualisation and measurement of social frailty, coupled with a lack of systematic reviews, hinder evidence synthesis and the development of targeted interventions. OBJECTIVE: This scoping review aimed to map current evidence on the definition, measurement tools, prevalence, associated factors and health-related outcomes of social frailty in individuals with heart failure. METHODS: Following the PRISMA-ScR guidelines, a comprehensive electronic search was conducted in June 2025 across eight databases: Web of Science, PubMed, CINAHL Complete, Scopus, Embase, Cochrane, CNKI and Wanfang. Search terms were guided by the Population-Concept-Context mnemonic, focusing on heart failure, social frailty, and healthcare or community settings and in accordance with the aim of the review. RESULTS: A total of 27 articles were included. No unified definition of social frailty was identified, and existing assessment tools exhibited heterogeneity. Prevalence rates varied widely across settings and measurement tools. Factors associated with social frailty included sociodemographic characteristics, socioeconomic status, clinical severity, psychological status and contextual factors. Social frailty was consistently linked to adverse outcomes such as diminished quality of life, increased rehospitalisation risk and higher mortality. CONCLUSIONS: The current literature highlights significant conceptual and methodological gaps in understanding social frailty in heart failure. Standardised definitions, validated assessment tools and deeper exploration of underlying mechanisms are needed to guide effective interventions and improve holistic care for people living with heart failure. IMPLICATIONS FOR PRACTICE: Routine assessment of social frailty, including living arrangements, perceived social support and social participation, may facilitate the early identification of older people with heart failure who are at increased clinical and social risk. Identification of social frailty may help uncover unmet social needs and facilitate timely referral to social and community resources. As coordinators of holistic care, nurses can promote multidisciplinary collaboration and support tailored interventions that address both symptom burden and social functioning, thereby helping to reduce functional limitations and social isolation. Technology-enabled approaches, such as digital health platforms, care robots and interactive tools, may provide additional opportunities to enhance social engagement, improve access to care and promote more holistic and person-centred heart failure management.
Yang et al. (Sun,) conducted a review in Heart failure (n=27). Social frailty was evaluated on Prevalence, associated factors, and health-related outcomes. Social frailty in heart failure is consistently linked to adverse outcomes such as diminished quality of life, increased rehospitalisation risk, and higher mortality.