Worldwide populations are aging, and age-related diseases and disabilities represent major challenges for societies because they place additional strains on the economy and the sustainability of public finances [
1]. Although the continuing increase in life expectancy is a major achievement, it presents the challenge of keeping older people healthy.
Healthy aging requires the proactive management of resources in an environment of increasing losses and declining gains that accompany aging [
2]. Healthy aging is expected to depend on older peoples’ abilities to self-regulate or self-manage their lives and aging processes. These abilities depend not only on the physical health aspects of aging (e.g., regular exercise and healthy eating) [
3‐
5], but also on the social and psychological aspects of life, such as regularly socializing with friends/family [
6]. The self-management of well-being (SMW) theory [
7] describes how older individuals can achieve well-being and is based on the notion that healthy aging is a lifelong process of realizing and sustaining well-being, even in the face of declining resources. For example, it includes the ability to look ahead and invest in resources (e.g., good health, good social relationships) that may contribute to health in the long term.
High levels of frailty are found among older people [
8,
9]; the prevalence of frailty is currently around 40%, and is expected to increase further as populations age [
10]. Prevalence of frailty, however, varies depending on how frailty is defined. Definitions of frailty are often found to be synonymous with disability [
11‐
13], comorbidity [
12], or advanced old age [
14]. According to Verbrugge [
15], frailty can be seen as a syndrome in which more areas of functioning decline with aging. In this way frailty is a precursor state of functional limitations and disability associated with the aging process itself such as the comorbidity of chronic diseases and multiple risk factors including psychosocial and functional limitations. Increasingly, however, frailty is considered a multidimensional geriatric syndrome [
16] consisting of physical, psychological, social, and environmental factors [
17,
18], which is also the approach we used in our study. Gobbens and colleagues [
19] defined this multidimensional concept of frailty as a dynamic state affecting an individual who experiences losses in one or more domains of human functioning (physical, psychological, social), which is caused by the influence of a range of variables and increases the risk of adverse outcomes. For example, frailty is known to increase the risks of falling, hospitalization, acute and chronic diseases, disability, and mortality [
8,
18,
20,
21]. Furthermore, it has been associated with increased health service utilization and healthcare costs [
22,
23]. As such, frailty represents a public health problem [
18] and its prevention is considered a priority by policymakers and healthcare organizations [
24]. For the effective promotion of healthy aging interventions must be initiated early [
25]. Interventions to promote healthy aging can be used to delay the onset of frailty or reduce its adverse outcomes among community-dwelling older people.
Although several studies have examined well-being and self-management abilities [
26‐
30] or frailty [
17‐
19] among older people, the relationships of self-management abilities, as described by the SMW theory [
7], and frailty to health have not yet been investigated in older populations. Thus, this study aimed to identify the relationships of self-management abilities and frailty to self-perceived health among community-dwelling older people while controlling for important individual characteristics, such as education, age, marital status, and gender.