Multidimensional Social Deprivation Impacts on Frailty in the Elderly: The Mediating Effect of Depression
Abstract
To investigate the mediating role of depression in the association between multidimensional social deprivation and frailty among the elderly.
Methods A total of 533 elderly individuals were enrolled from a district in Chengdu using a convenience sampling method. The participants responded to a questionnaire survey. Spearman rank correlation coefficient was employed to assess the correlations among social deprivation, depression, and frailty. MacKinnon’s product-of-coefficients method was used to test the significance of the mediating effect of depression between social deprivation and frailty.
Results Among the participants, the average score for social deprivation among the participants was 48.9±7.1, the depression detection rate was 12.8%, and the frailty incidence rate was 8.4%. Social deprivation was positively correlated with frailty (r=0.212, P<0.001) and depression (r=0.399, P<0.001), while depression was positively correlated with frailty (r=0.248, P<0.001). The results of the mediation analysis showed that depression partially mediated the relationship between social deprivation and frailty (P<0.05), accounting for 64.95% of the mediation effect. Specifically, depression partially mediated the relationship between socio-economic status, comprehensive feeling, and frailty (P<0.05), accounting for 70.30% and 64.76% of the mediating effect, respectively. Depression fully mediated the relationship between family and social support, political and social participation dimensions, and frailty (P<0.05).
Conclusion Social deprivation can influence frailty in elderly people, with depression partially mediating this association.
Keywords: Social deprivation, Frailty, Depression, Mediating effect. The elderly
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National Bureau of Statistics of China. Statistical communiqué of the People’s Republic of China on the 2023 national economic and social development. China Statistics, 2024(3): 4-21.
FELIX J, MARTINEZ D T I, DIAZ-DEL C E, et al. Frailty and biological age. Which best describes our aging and longevity? Mol Aspects Med, 2024, 98: 101291. doi: 10.1016/j.mam.2024.101291.
PENG X Y, SONG M F, ZHANG W, et al. Status quo and influencing factors of social frailty for the elderly in community. Chin Nurs Res, 2021, 35(19): 3401–3406. doi: 10.12102/j.issn.1009-6493.2021.19.004.
DENT E, MARTIN F C, BERGMAN H, et al. Management of frailty: opportunities, challenges, and future directions. Lancet, 2019, 394(10206): 1376–1386. doi: 10.1016/S0140-6736(19)31785-4.
ZHANG Y Y, RAN G Q, DENG K Y, et al. Constructing a multidimensional social deprivation scale for the elderly based on Delphi method. J Prev Med Inf, 2024, 40(3): 273–277. doi: 10.19971/j.cnki.1006-4028.230709.
MONTEIL D, WALRAND S, VANNIER-NITENBERG C, et al. The relationship between frailty, obesity and social deprivation in non-institutionalized elderly people. J Nutr Health Aging, 2020, 24(8): 821–826. doi: 10.1007/s12603-020-1465-6.
GIOVANNELLI J, PINON A, LENAIN M, et al. The relationship between social deprivation and a frailty index of cumulative deficits in french middle-aged caregivers. BMC Geriatr, 2022, 22(1): 15. doi: 10.1186/s12877-021-02736-3.
BARANYI G, WELSTEAD M, CORLEY J, et al. Association of life-course neighborhood deprivation with frailty and frailty progression from ages 70 to 82 years in the lothian birth cohort 1936. Am J Epidemiol, 2022, 191(11): 1856–1866. doi: 10.1093/aje/kwac134.
Huang Z Y. Research on the relationship between socioeconomic status, relative deprivation and residents' physical and mental health. Wuhan: Huazhong University of Science and Technology, 2019.
HU M X. The impact of relative deprivation, social capital on health of urban and rural residents in China. Tianjin: Tianjin University of Technology, 2021.
HUANG Q B, WANG X H, CHEN G. Reliability and validity of 10-item CES-D among middle aged and older adults in China. Chin J Health Psychol, 2015, 23(7): 1036–1041. doi: 10.13342/j.cnki.cjhp.2015.07.023.
ZHOU L, MA X, WANG W. Relationship between cognitive performance and depressive symptoms in Chinese older adults: the China Health And Retirement Longitudinal Study (CHARLS). J Affect Disord, 2021, 281: 454–458. doi: 10.1016/j.jad.2020.12.059.
ABELLAN VAN KAN G, ROLLAND Y, BERGMAN H, et al. The I.A.N.A Task Force on frailty assessment of older people in clinical practice. J Nutr Health Aging, 2008, 12(1): 29–37. doi: 10.1007/BF02982161.
GAO P, WANG L, WANG H Y, et al. Correlation of the frail scale and frail index to the rehabilitation of elderly patients after hip replacement. Chin J Rehabil Med, 2024, 39(4): 529–534. doi: 10.3969/j.issn.1001-1242. 2024.04.011.
HAN J, WANG J Q, XIE B Q, et al. Comparison of consistency and validity of fried frailty phenotype, FRAIL scale and Edmonton Frailty scale for frailty screening among community-dwelling older adults. Chin Gen Pract, 2021, 24(21): 2669–2675. doi: 10.12114/j.issn.1007-9572.2021. 00.451.
KONG J H, ZHANG J, FAN X X, et al. Application of two frailty assessment tools in the screening of frail elderly persons in the community. Chin J Clin Health, 2019, 22(5): 604–608. doi: 10.3969/J.issn. 1672-6790.2019.05.008.
FANG J, WEN Z L, ZHANG M Q. Mediation analysis of categorical variables. J Psych Sci, 2017, 40(2): 471–477. doi: 10.16719/j.cnki.1671-6981.20170233.
TOFIGHI D, MACKINNON D P. Rmediation: an R package for mediation analysis confidence intervals. Behav Res Methods, 2011, 43(3): 692–700. doi: 10.3758/s13428-011-0076-x.
IACOBUCCI D. Mediation analysis and categorical variables: the final frontier. J Consum Psychol, 2012, 22(4): 582–594. doi: 10.1016/j.jcps. 2012.03.006.
ZHOU Q, LI Y, GAO Q, et al. Prevalence of frailty among chinese community-dwelling older adults: a systematic review and meta-analysis. Int J Public Health, 2023, 68: 1605964. doi: 10.3389/ijph.2023.1605964.
HOU S J, DING Y, GUO X L, et al. Incidence and influencing factors of frailty in chinese community-dwelling older adults: a meta-analysis. J New Med, 2024, 34(3): 301–311. doi: 10.12173/j.issn.1004-5511. 202311001.
WANG Y, CHEN Q, LIU L R. detection rate of depression and its influencing factors in chinese elderly: a meta-analysis. Chin Gen Pract, 2023, 26(34): 4329–4335. doi: 10.12114/j.issn.1007-9572.2023.0269.
PARTOS K, MAJOR D, DOSA N, et al. Diagnosis rates, therapeutic characteristics, lifestyle, and cancer screening habits of patients with diabetes mellitus in a highly deprived region in hungary: a cross-sectional analysis. Front Endocrinol (Lausanne), 2024, 15: 1299148. doi: 10.3389/fendo.2024.1299148.
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