Objective   To examine the prevalence of frailty and its association with health status and lifestyle among oldest-old empty-nesters in urban Tangshan of Hebei province.

  Methods   We recruited 2 529 urban residents aged≥ 75 years and living alone with stratified random cluster sampling from 32 communities covered by 10 community health care centers in Tangshan city. Then we conducted household interviews among the participants between July 2016 and January 2017 with Comprehensive Frailty Assessment Instrument (CFAI), Health Promoting Lifestyle Profile (HPLP-Ⅱ), and Medical Outcomes Study 36-Item Short-Form Health (SF-36).

  Results   Among the participants, the average overall score for frailty was 46.88 ± 11.879, indicating a serious frailty status; and for frailty domains, social breakdown was the most obvious, with a mean score of 3.67 ± 0.832. Multivariate analyses demonstrated that major frailty-related factors included marital status (married: β = – 0.385, widowed: – 0.391, separated or divorced:0.385), monthly income (501 – 1 000 RMB yuan: β = 0.004, 1 001 – 3 000:0.036, 3 001 – 4 999:0.018, ≥ 5 000:0.018), physiological function (β = 0.213), social function (β = 0.101), role-physical (β = 0.112), mental health (β = 0.152), emotional function (β = 0.053), vitality (β=0.203), and general health (β = 0.140) among the participants.

  Conclusion   Severe frailty is prevalent among oldest-old empty-nesters in urban Tangshan and effective health promotion should be conducted to improve quality of life among the population.