Background <p>Earthquakes are among the most devastating natural events that can cause physical, socio-economic and psychological devastation. It is thought that the negative situations caused by earthquakes can cause traumatic processes especially in older adults in vulnerable groups. The aim of this study is to determine the mediating role of earthquake fear in the relationship between spiritual well-being and frailty levels among older adult earthquake survivors.</p> Method <p>The study is descriptive and correlational. The study population consists of 289 individuals aged 65 and older who experienced the February 6 earthquake. Data were collected face-to-face using Socio-Demographic Questionnaire Form, Spiritual Well-being Scale, Frailty Assessment and Screening Tool, and Earthquake Fear Scale.</p> Results <p>It was determined that spiritual well-being has a negative and significant effect on earthquake fear (β = -0.363, <i>p</i> &lt; 0.001). It was determined that spiritual well-being has a negative and significant effect on frailty (β = -0.360, <i>p</i> &lt; 0.001), and that this effect decreased when earthquake fear was added to the model (β = -0.310, <i>p</i> &lt; 0.001). According to the model, earthquake fear had a positive and significant effect on frailty (β = 0.138, <i>p</i> = 0.019), meaning that as earthquake fear increased, so did the level of frailty. Earthquake fear was found to have a partial mediating role in the relationship between frailty and spiritual well-being (β = -0.050, 95% CI [-0.101, -0.005]).</p> Conclusion <p>It is suggested that alleviating the psychological effects of earthquakes, reducing fear levels, improving frailty levels, and enhancing spiritual well-being are effective ways to support older adults who have experienced earthquakes. This study will be critical in the development of post-earthquake interventions and support programs for older adults.</p>