The relationship between disability, anxiety and depression in older adults with chronic disease comorbidities: the mediating role of frailty

作者：Hui‐Ju Wen, Qingyun Mao, Zhixia Jiang, Heting Liang, Yumeng Zhang, Shaoting Yang, Yunting Li, Yan Xiong, Xiaoli Yuan · 发表于：BMC Geriatrics · 年份：2025 · DOI：10.1186/s12877-025-06610-4 · 被引用次数：5 · 研究领域：Frailty in Older Adults、Chronic Disease Management Strategies、Aging, Health, and Disability

BACKGROUND: The global aging crisis has intensified concerns about disability, frailty, anxiety, and depression in older adults, particularly those with multimorbidity. However, the interrelationships among these factors remain not fully understood. This study investigates the mediating role of frailty between disability and anxiety/depression in this population. METHODS: A cross-sectional study was conducted from October 2022 to January 2023, enrolling 4,372 older adults with multimorbidity from 3 tertiary hospitals, 5 secondary hospitals, and 3 community health centers in Zunyi, China. Data were collected using validated instruments: Activities of Daily Living (ADL), the Self-Rating Anxiety Scale (SAS), Generalized Anxiety Disorder-7 (GAD-7), Geriatric Depression Scale-Short Form (GDS-15), and Frailty Phenotype. Spearman correlation, binary logistic regression, and mediation analysis (SPSS PROCESS 3.5) with Bootstrap testing (5,000 resamples) were employed. RESULTS: Among participants, 437 (10.0%) exhibited disability. Significant correlations were observed between disability and anxiety/depression (r = 0.32-0.41, p < 0.001). Frailty partially mediated the disability-anxiety (50.45% of total effect) and disability-depression (48.17%) relationships (p < 0.001). CONCLUSION: Frailty serves as a critical mediator between disability, anxiety and depression in older adults with chronic disease comorbidity. Targeted interventions addressing disability and frailty may significantly...