With the accelerating aging of the population, pre-frailty, as a reversible "golden window of intervention", is crucial for promoting healthy aging. However, there is a lack of in-depth research on how community-dwelling older adults understand and perceive frailty and pre-frailty, and their views on related screening and management.

To explore the conceptualization of pre-frailty and perspectives on its screening and management among community-dwelling older adults with pre-frailty, and to analyze the facilitators and barriers, so as to provide a basis for developing efficient and acceptable early intervention programs.

Based on the capability, opportunity, motivation-behaviour (COM-B) model and the Theoretical Domains Framework (TDF), semi-structured interviews were conducted in August 2025 with 14 community-dwelling older adults identified as pre-frail in previous research. Participants were recruited using purposive sampling and snowball sampling from Xuxinzhuang and Taoranting Community Health Centers in Beijing. Open-ended questions were used to guide participants in describing their understanding of pre-frailty, their willingness to participate in screening and management, and the influencing factors. Directed content analysis was used to collate and analyze the interview data.

The study found that while older adults' conceptualization of "pre-frailty" was diverse and limited, they showed a strong willingness to participate in screening and interventions. Their needs were personalized and diverse, including a desire for authoritative knowledge, professional guidance and flexible service models. Facilitators included: sound family/community support, convenient exercise environments, trusting relationships with primary care and intrinsic motivation to reduce burden on children and maintain self-reliance. Barriers included: lack of health knowledge and difficulty in discerning information, uneven distribution of community resources and public services, insufficient trust in primary healthcare services, and behavioral inertia due to lack of confidence among some older adults.

There is a significant unmet need and high willingness to participate in screening and management among community-dwelling older adults with pre-frailty. The construction of future intervention strategies requires multi-dimensional collaboration: enhancing cognition and skills through health education (Capability), optimizing the community environment and primary healthcare services to provide resource support (Opportunity), and fully utilizing their intrinsic health motivation to design personalized programs (Motivation). This is of great significance for seizing the intervention window for pre-frailty and advancing the healthy aging strategy.

随着人口老龄化加剧，衰弱前期作为可逆的"黄金干预窗口"，对其早期识别与管理是促进健康老龄化的关键。然而，目前国内针对社区老年人对衰弱及衰弱前期的认知与感受、对相关筛查和管理的态度，仍缺乏深入研究。

了解社区衰弱前期老年人对衰弱前期的概念认知，以及其对筛查与管理的观点，分析开展衰弱前期筛查与管理的促进因素与阻碍因素，为构建高效、可接受的早期干预方案提供依据。

基于能力、动机、机会-行为（COM-B）模型和理论域框架,于2025年8月采用目的抽样法和滚雪球式抽样法，从北京市徐辛庄、陶然亭社区卫生服务中心辖区内选取经前期研究筛查为衰弱前期的老年人（n=14）进行半结构式访谈。访谈以开放式问题引导老年人描述对衰弱前期的理解、参与筛查与管理的意愿及影响因素，采用定向内容分析法对访谈资料进行整理与分析。

老年人对衰弱前期概念认知呈现多样性和局限性，但参与筛查与干预的意愿强烈。需求呈现个性化与多元化，包括对权威知识、专业指导及灵活服务模式的渴望。促进因素包括：健全的家庭/社区支持、便利的锻炼环境、与基层医疗的信任关系、为子女减负和维持自理的内在动机。阻碍因素包括：健康知识匮乏与信息辨别困难、社区资源与公共服务不均、对基层医疗服务信任度不足、部分老年人因信心匮乏导致"行为冻结"。

社区衰弱前期老年人对筛查与管理存在巨大未被满足的需求和高参与意愿。未来干预策略的构建需多维度协同：通过健康教育提升认知与技能（能力），优化社区环境与基层医疗服务以提供资源支持（机会），充分利用其内在健康动机设计个性化方案（动机）。此举对抓住衰弱前期干预窗口、推进健康老龄化战略具有重要意义。