Impact of Frailty on Cognitive Function in Chinese Older Adults: a Moderated Chain-mediated Effect
摘要
Background Cognitive impairment is one of the serious risk factors affecting the quality of life in the elderly. Some studies have found an association between frailty and cognitive function, but research on mediating and moderating effects between the two is relatively scarce. Objective To explore the influence of frailty on cognitive function, and to investigate the mediating role of activities of daily living and depressive symptoms between frailty and cognitive function. Additionally, the moderating effect of social participation will be analysed. Methods Using data from the 2018 China Longitudinal Healthy Longevity Survey (CLHLS), 8 173 individuals aged 65 and older were selected to obtain relevant information on frailty, cognitive function, activities of daily living, depressive symptoms, social participation, and demographic data among the elderly. The differences in cognitive function among elderly individuals with different characteristics were analyzed. Pearson correlation analysis was employed to investigate the interrelationships between the variables. Stratified regression was utilised to examine the impact of frailty on cognitive function. The Process macro programme was used to test the chain mediating role of activities of daily living and depressive symptoms between frailty and cognitive function, and the moderating effect of social participation within it. Results Of the 8 173 participants, 1 769 (21.6%) had cognitive impairment and all variables were correlated. Stratified regression analyses showed frailty negatively predicts cognitive function (B=-2.862, P<0.001). The results of the chain-mediated effects analysis showed that the activities of daily living (B=-1.713, 95%CI=-1.944 to -1.498) and depressive symptoms (B=-0.435, 95%CI=-0.531 to -0.345) mediated the link between cognitive function and frailty to some extent. The interaction term between frailty and social participation (B=1.140, 95%CI=0.822 to 1.457) as well as the interaction ter