The association between multimorbidity patterns and physical frailty among middle-aged and older community-dwelling adults: the mediating role of depressive symptoms
BackgroundThis study aimed to investigate the association between multimorbidity and frailty, and the potential mediating role of depressive symptoms in Chinese middle-aged and older community-dwelling adults.MethodsWe selected a total of 5,232 adults with two or more chronic diseases from the China...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1527982/full |
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| author | Yuhan Geng Yuhan Geng Ming Zhou Ming Zhou Yangxiaoxue Liu Tianshu Zhao Jiali Zhang Min Xin Wenxin Wang Gongzi Zhang Liping Huang |
| author_facet | Yuhan Geng Yuhan Geng Ming Zhou Ming Zhou Yangxiaoxue Liu Tianshu Zhao Jiali Zhang Min Xin Wenxin Wang Gongzi Zhang Liping Huang |
| author_sort | Yuhan Geng |
| collection | DOAJ |
| description | BackgroundThis study aimed to investigate the association between multimorbidity and frailty, and the potential mediating role of depressive symptoms in Chinese middle-aged and older community-dwelling adults.MethodsWe selected a total of 5,232 adults with two or more chronic diseases from the China Health and Retirement Longitudinal Study (CHARLS) database. Clusters of participants with similar multimorbidity patterns were identified through fuzzy c-means cluster analyses. The cross-sectional association between multimorbidity and frailty was measured through logistic regression analyses. Mediation analysis was applied to examine direct and indirect associations within the counterfactual framework.ResultsAt baseline, we identified five multimorbidity patterns. Two of these patterns significantly increased the risk of frailty compared to a non-specific pattern. Depression mediated 35.20% of the effect of multimorbidity on frailty (p = 0.042). Notably, in adults aged 60 years and older, this mediation accounted for 69.84% of the total effect, surpassing the direct impact of multimorbidity on frailty. Among individuals with economic support (0.020, 95% CI: 0.002–0.040), high school education (0.062, 95% CI: 0.007–0.120), and no alcohol consumption (0.024, 95% CI: 0.003–0.050), depression entirely mediated the impact of comorbidities.ConclusionThis study reveals strong links between specific multimorbidity patterns and physical frailty, with depression significantly mediating these effects, particularly in certain populations. Findings emphasize tailored mental health interventions’ necessity in specific groups. |
| format | Article |
| id | doaj-art-d47c2d8bcbba469a80d78dc9d992169d |
| institution | OA Journals |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-d47c2d8bcbba469a80d78dc9d992169d2025-08-20T01:55:41ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-05-011310.3389/fpubh.2025.15279821527982The association between multimorbidity patterns and physical frailty among middle-aged and older community-dwelling adults: the mediating role of depressive symptomsYuhan Geng0Yuhan Geng1Ming Zhou2Ming Zhou3Yangxiaoxue Liu4Tianshu Zhao5Jiali Zhang6Min Xin7Wenxin Wang8Gongzi Zhang9Liping Huang10Medical School of Chinese PLA, Beijing, ChinaDepartment of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaMedical School of Chinese PLA, Beijing, ChinaDepartment of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaDepartment of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaDepartment of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaDepartment of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaDepartment of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaDepartment of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaDepartment of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaDepartment of Rehabilitation Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing, ChinaBackgroundThis study aimed to investigate the association between multimorbidity and frailty, and the potential mediating role of depressive symptoms in Chinese middle-aged and older community-dwelling adults.MethodsWe selected a total of 5,232 adults with two or more chronic diseases from the China Health and Retirement Longitudinal Study (CHARLS) database. Clusters of participants with similar multimorbidity patterns were identified through fuzzy c-means cluster analyses. The cross-sectional association between multimorbidity and frailty was measured through logistic regression analyses. Mediation analysis was applied to examine direct and indirect associations within the counterfactual framework.ResultsAt baseline, we identified five multimorbidity patterns. Two of these patterns significantly increased the risk of frailty compared to a non-specific pattern. Depression mediated 35.20% of the effect of multimorbidity on frailty (p = 0.042). Notably, in adults aged 60 years and older, this mediation accounted for 69.84% of the total effect, surpassing the direct impact of multimorbidity on frailty. Among individuals with economic support (0.020, 95% CI: 0.002–0.040), high school education (0.062, 95% CI: 0.007–0.120), and no alcohol consumption (0.024, 95% CI: 0.003–0.050), depression entirely mediated the impact of comorbidities.ConclusionThis study reveals strong links between specific multimorbidity patterns and physical frailty, with depression significantly mediating these effects, particularly in certain populations. Findings emphasize tailored mental health interventions’ necessity in specific groups.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1527982/fullmultimorbidityfrailtydepressive symptomscluster analysismediation analysis |
| spellingShingle | Yuhan Geng Yuhan Geng Ming Zhou Ming Zhou Yangxiaoxue Liu Tianshu Zhao Jiali Zhang Min Xin Wenxin Wang Gongzi Zhang Liping Huang The association between multimorbidity patterns and physical frailty among middle-aged and older community-dwelling adults: the mediating role of depressive symptoms Frontiers in Public Health multimorbidity frailty depressive symptoms cluster analysis mediation analysis |
| title | The association between multimorbidity patterns and physical frailty among middle-aged and older community-dwelling adults: the mediating role of depressive symptoms |
| title_full | The association between multimorbidity patterns and physical frailty among middle-aged and older community-dwelling adults: the mediating role of depressive symptoms |
| title_fullStr | The association between multimorbidity patterns and physical frailty among middle-aged and older community-dwelling adults: the mediating role of depressive symptoms |
| title_full_unstemmed | The association between multimorbidity patterns and physical frailty among middle-aged and older community-dwelling adults: the mediating role of depressive symptoms |
| title_short | The association between multimorbidity patterns and physical frailty among middle-aged and older community-dwelling adults: the mediating role of depressive symptoms |
| title_sort | association between multimorbidity patterns and physical frailty among middle aged and older community dwelling adults the mediating role of depressive symptoms |
| topic | multimorbidity frailty depressive symptoms cluster analysis mediation analysis |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1527982/full |
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