Introduction: A globally ageing population means frailty, and its precursor pre-frailty, are major public health concerns. Frailty is typically associated with older adults; however, emerging evidence suggests that pre-frailty also impacts middle-aged adults. Understanding the behavioural and psychological correlates of pre-frailty and frailty in middle-aged adults from 40 years would enable identification of potentially at-risk individuals and inform interventions. This study aimed to examine associations between physiological and psychological factors, and frailty and pre-frailty in adults aged ≥40 years.

Method: Cross-sectional study of community-dwelling adults aged 40+. Participants completed online surveys assessing frailty status, physical activity, co-morbidities, quality of life, loneliness, social isolation, and attitudes towards ageing.

Results: The analysis included 321 participants (mean age = 56, 82.6% female). Participants were 35% non-frail, 60% pre-frail, and 5% frail. Pre-frail felt older than their chronological age (F=22.69, p<.001, η²=.125). No significant differences in physical activity time was observed across frailty groups. The pre-frail and frail groups reported significantly poorer mental and physical health scores (F=30.40, p<.001, η²=.161; F=4.48, p=.012, η²=.027). Pre-frail and frail participants reported more negative attitudes toward aging (F=31.04, p < .001, η²=.167) and higher levels of loneliness compared to non-frail participants (F=19.04, p<.001, η²=.107).

Conclusions: These findings underscore the relationship of behavioural and psychological factors with pre-frailty in middle-aged and older adults. Early and targeted interventions in middle-age could potentially delay or prevent the progression to frailty, advocating for a holistic approach to wellness in this age group.