Abstract: Background　Frailty, as a common geriatric health syndrome, has attracted extensive attention due to its association with multiple adverse health outcomes. However, the heterogeneity of frailty and its related psychosocial factors among community-dwelling older adults remain insufficiently explored. Objective　To identify the potential latent profiles of frailty among community-dwelling older adults and, based on the Conservation of Resources Theory, to examine the relationships between resource loss and resource gain factors and different frailty profiles. Methods　From May to October 2024, a multi-stage stratified sampling method was employed to select 480 community-dwelling older adults from Shijiazhuang as participants. Frailty was assessed using the Tilburg Frailty Indicator (TFI). Anxiety, depression, loneliness, and social support levels were measured using the Generalized Anxiety Disorder Scale (GAD-7), the Geriatric Depression Scale-15 (GDS-15), the 6-item University of California at Los Angeles (UCLA) Loneliness Scale (ULS-6), and the Social Support Rating Scale (SSRS), respectively. Latent profile analysis was used to identify frailty categories, and the generalized structural equation model was applied to examine the effects of resource loss and gain factors on these different profiles. Results　A total of 479 valid questionnaires were collected, resulting in an effective response rate of 99.79%. Latent profile analysis identified three latent profiles of frailty: (1) The "High Physical-Social Frailty" profile (13.15%) was characterized by a higher proportion of women, a higher proportion of individuals living alone or not married, lower social support, and higher levels of depression and loneliness. (2) The "Moderate but Stable Frailty" profile (59.71%) represented the largest group, mainly consisting of married individuals, with the highest level of social support and relatively stable overall functioning. (3) The "Low Psychological-Social Frailty" profile (27.14%) was predominantly male and showed better economic status, social support, and psychological well-being. Generalized structural equation model revealed significant differences in the associations between resource factors and frailty profiles. For the "High Physical-Social Frailty" profile, resource loss was positively associated with frailty profile (β=0.246, P<0.001), whereas resource gain was negatively associated (β=-0.404, P<0.001). For the "Moderate but Stable Frailty" profile, only resource gain was positively associated with frailty profile (β=0.605, P<0.001). Social support did not show a significant moderating effect between resource loss and frailty profiles (P>0.05), supporting the "Independent Dual-Path Model of Resource Loss and Gain". Conclusion　Frailty among community-dwelling older adults is heterogeneous, and different frailty profiles exhibit distinct associations with resource loss and resource gain factors. Community health management strategies should be tailored to specific frailty profiles, focusing on enhancing resource gains and reducing resource losses to improve health outcomes and quality of life among older adults.

Key words: Frailty, Aged, Latent profile analysis, Resource loss factors, Resource gain factors, Community health management

摘要： 背景　衰弱作为一种常见的老年健康综合征，因与多种不良健康结局相关而受到广泛关注，但社区老年人衰弱的异质性特征及其相关心理社会因素尚缺乏深入研究。目的　识别社区老年人衰弱的潜在类别，并基于资源保存理论探讨资源损失因素与资源增益因素与不同衰弱类别之间的关系。方法　2024年5—10月，采用多阶段分层抽样方法，选取石家庄市480名社区老年人作为研究对象。Tilburg衰弱评估量表（TFI）评估衰弱状况，广泛性焦虑障碍量表（GAD-7）、简版老年抑郁量表（GDS-15）、6条目孤独感量表简版（ULS-6）及社会支持评定量表（SSRS）分别评估其焦虑、抑郁、孤独感及社会支持水平。采用潜在剖面分析识别衰弱类别，并运用广义结构方程模型检验增损因素与不同衰弱类别之间的关系。结果　回收有效问卷479份，有效率为99.79%。潜在剖面分析识别出3种衰弱潜在类别。其中，“高躯体-社会衰弱型”（13.15%）以女性为主，独居及非在婚比例较高，社会支持水平较低，抑郁与孤独感水平较高；“中衰稳健型”（59.71%）为社区老年人的主要群体，多为在婚状态，社会支持水平最高，整体功能相对稳定；“低心理-社会衰弱型”（27.14%）以男性为主，经济状况、社会支持与心理状态均较好。广义结构方程模型显示，增损因素与不同衰弱类别的关系差异显著。资源损失因素与“高躯体-社会衰弱型”呈正相关（β=0.246，P<0.001）；资源增益因素与“高躯体-社会衰弱型”呈负相关（β=-0.404，P<0.001），与“中衰稳健型”呈正相关（β=0.605，P<0.001）。社会支持在资源损失因素与衰弱类别之间未表现出显著调节作用（P>0.05），支持了“资源损失-增益双路径独立模型”。结论　社区老年人衰弱存在明显异质性，不同衰弱类别与资源损失因素和资源增益因素的关联特征存在差异。社区健康管理可结合不同衰弱类别特征，采取针对性的促进和维持增益资源、减少损失资源的策略，改善衰弱老年人的健康和生活质量。

关键词: 衰弱, 老年人, 潜在剖面分析, 资源损失因素, 资源增益因素, 社区健康管理