The mediating and joint effects of depression in the association between cardiovascular health and frailty in middle-aged and elderly people: evidence from NHANES

ObjectiveThis study investigates the correlation between Life’s Essential 8 (LE8), a cardiovascular health (CVH) metric, and frailty in middle-aged and elderly individuals in the United States, also examining how depression mediates this relationship.MethodsParticipants from the NHANES 2005-2018 wer...

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Main Authors: Qiaoli Ma, Zhijuan Zou, Yanpeng Liu, Lei Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1578743/full
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author Qiaoli Ma
Zhijuan Zou
Yanpeng Liu
Lei Zhang
author_facet Qiaoli Ma
Zhijuan Zou
Yanpeng Liu
Lei Zhang
author_sort Qiaoli Ma
collection DOAJ
description ObjectiveThis study investigates the correlation between Life’s Essential 8 (LE8), a cardiovascular health (CVH) metric, and frailty in middle-aged and elderly individuals in the United States, also examining how depression mediates this relationship.MethodsParticipants from the NHANES 2005-2018 were analyzed for correlations between LE8 and frailty, along with the combined effects of LE8 and depression using multiple logistic regression. Dose-response relationships were assessed using restricted cubic splines (RCS), and mediation analysis explored depression’s role. Sensitivity and subgroup analyses were conducted for result stability.ResultsThe study included 8,982 participants, with 3,103 frailty events. A higher LE8 score was significantly associated with a reduced risk of frailty, with adjusted odds ratios for the medium and high CVH groups at 0.49 (95% CI: 0.40-0.58, p < 0.001) and 0.21 (95% CI: 0.13-0.33, p < 0.001), respectively. The RCS model showed a negative dose-response relationship. No significant association was found between LE8 and frailty in the depressed population, where depression mediated 32.13% of the relationship.ConclusionMaintaining good cardiovascular health, as measured by LE8, is key to reducing frailty risk in middle-aged and elderly individuals. This underscores the importance of cardiovascular health assessments and targeted health programs to improve quality of life.
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publisher Frontiers Media S.A.
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spelling doaj-art-d378eba137ff4e29a63ead2987177e6a2025-08-20T03:08:32ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-04-011610.3389/fpsyt.2025.15787431578743The mediating and joint effects of depression in the association between cardiovascular health and frailty in middle-aged and elderly people: evidence from NHANESQiaoli Ma0Zhijuan Zou1Yanpeng Liu2Lei Zhang3Department of Cardiology, Zibo Central Hospital, Zibo, Shandong, ChinaDepartment of Orthopedic Trauma, Zibo Central Hospital, Zibo, Shandong, ChinaEmergency Department, Zibo Central Hospital, Zibo, Shandong, ChinaDepartment of Cardiology, Zibo Central Hospital, Zibo, Shandong, ChinaObjectiveThis study investigates the correlation between Life’s Essential 8 (LE8), a cardiovascular health (CVH) metric, and frailty in middle-aged and elderly individuals in the United States, also examining how depression mediates this relationship.MethodsParticipants from the NHANES 2005-2018 were analyzed for correlations between LE8 and frailty, along with the combined effects of LE8 and depression using multiple logistic regression. Dose-response relationships were assessed using restricted cubic splines (RCS), and mediation analysis explored depression’s role. Sensitivity and subgroup analyses were conducted for result stability.ResultsThe study included 8,982 participants, with 3,103 frailty events. A higher LE8 score was significantly associated with a reduced risk of frailty, with adjusted odds ratios for the medium and high CVH groups at 0.49 (95% CI: 0.40-0.58, p < 0.001) and 0.21 (95% CI: 0.13-0.33, p < 0.001), respectively. The RCS model showed a negative dose-response relationship. No significant association was found between LE8 and frailty in the depressed population, where depression mediated 32.13% of the relationship.ConclusionMaintaining good cardiovascular health, as measured by LE8, is key to reducing frailty risk in middle-aged and elderly individuals. This underscores the importance of cardiovascular health assessments and targeted health programs to improve quality of life.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1578743/fullLife’s Essential 8frailtydepressionNHANESCVH
spellingShingle Qiaoli Ma
Zhijuan Zou
Yanpeng Liu
Lei Zhang
The mediating and joint effects of depression in the association between cardiovascular health and frailty in middle-aged and elderly people: evidence from NHANES
Frontiers in Psychiatry
Life’s Essential 8
frailty
depression
NHANES
CVH
title The mediating and joint effects of depression in the association between cardiovascular health and frailty in middle-aged and elderly people: evidence from NHANES
title_full The mediating and joint effects of depression in the association between cardiovascular health and frailty in middle-aged and elderly people: evidence from NHANES
title_fullStr The mediating and joint effects of depression in the association between cardiovascular health and frailty in middle-aged and elderly people: evidence from NHANES
title_full_unstemmed The mediating and joint effects of depression in the association between cardiovascular health and frailty in middle-aged and elderly people: evidence from NHANES
title_short The mediating and joint effects of depression in the association between cardiovascular health and frailty in middle-aged and elderly people: evidence from NHANES
title_sort mediating and joint effects of depression in the association between cardiovascular health and frailty in middle aged and elderly people evidence from nhanes
topic Life’s Essential 8
frailty
depression
NHANES
CVH
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1578743/full
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