A serial mediation model of physical exercise and loneliness: the role of frailty and depression

Abstract Background Frailty, depression, and loneliness are significant risk factors that hinder successful aging. Physical exercise has been widely recognized as an effective intervention to improve both the physical and mental health of older adults. Guided by the integral conceptual model of frai...

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Main Authors: Song Gu, Shiling Liu
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Geriatrics
Subjects:
Online Access:https://doi.org/10.1186/s12877-025-05988-5
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author Song Gu
Shiling Liu
author_facet Song Gu
Shiling Liu
author_sort Song Gu
collection DOAJ
description Abstract Background Frailty, depression, and loneliness are significant risk factors that hinder successful aging. Physical exercise has been widely recognized as an effective intervention to improve both the physical and mental health of older adults. Guided by the integral conceptual model of frailty, this study aimed to explore the relationships among physical exercise, frailty, depression, and loneliness, providing theoretical support for designing targeted exercise interventions to alleviate loneliness in older adults. Methods This study employed a structural equation model (SEM) and bootstrap method to examine a serial mediation model, investigating the roles of frailty and depression in the relationship between physical exercise and loneliness. A descriptive and cross-sectional design was adopted, and data were collected from 505 older adults aged 60 and above in China between February and July 2023. The data were collected using the Physical Activity Rating Scale (PARS-3), the UCLA Loneliness Scale (ULS-8), the Tilburg Frailty Indicator (TFI) and the Patient Health Questionnaire-9 (PHQ-9). Results The findings revealed a significant direct negative relationship between physical exercise and loneliness (Effect = -0.063, 95% CI: -0.085 to -0.040). Furthermore, frailty and depression were found to mediate this relationship both independently and serially. The independent mediation effect of frailty was − 0.072 (95% CI: -0.090 to -0.055), while the independent mediation effect of depression was − 0.010 (95% CI: -0.019 to -0.003). The serial mediation effect of frailty and depression was − 0.007 (95% CI: -0.011 to -0.002). Collectively, the total indirect effect of the three mediation pathways accounted for 58.55% of the observed relationship. Conclusions This study demonstrated a negative correlation between physical exercise and loneliness among older adults, with frailty and depression serving as significant mediators in this relationship. The findings suggest that physical exercise may alleviate loneliness in older adults by enhancing physiological function and fostering psychosocial empowermen.
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spelling doaj-art-eaf46f11e6e14144843ffc7f03efa3282025-08-20T02:25:13ZengBMCBMC Geriatrics1471-23182025-05-0125111110.1186/s12877-025-05988-5A serial mediation model of physical exercise and loneliness: the role of frailty and depressionSong Gu0Shiling Liu1College of Physical Education and Health Sciences, Zhejiang Normal UniversityCollege of Physical Education and Health Sciences, Zhejiang Normal UniversityAbstract Background Frailty, depression, and loneliness are significant risk factors that hinder successful aging. Physical exercise has been widely recognized as an effective intervention to improve both the physical and mental health of older adults. Guided by the integral conceptual model of frailty, this study aimed to explore the relationships among physical exercise, frailty, depression, and loneliness, providing theoretical support for designing targeted exercise interventions to alleviate loneliness in older adults. Methods This study employed a structural equation model (SEM) and bootstrap method to examine a serial mediation model, investigating the roles of frailty and depression in the relationship between physical exercise and loneliness. A descriptive and cross-sectional design was adopted, and data were collected from 505 older adults aged 60 and above in China between February and July 2023. The data were collected using the Physical Activity Rating Scale (PARS-3), the UCLA Loneliness Scale (ULS-8), the Tilburg Frailty Indicator (TFI) and the Patient Health Questionnaire-9 (PHQ-9). Results The findings revealed a significant direct negative relationship between physical exercise and loneliness (Effect = -0.063, 95% CI: -0.085 to -0.040). Furthermore, frailty and depression were found to mediate this relationship both independently and serially. The independent mediation effect of frailty was − 0.072 (95% CI: -0.090 to -0.055), while the independent mediation effect of depression was − 0.010 (95% CI: -0.019 to -0.003). The serial mediation effect of frailty and depression was − 0.007 (95% CI: -0.011 to -0.002). Collectively, the total indirect effect of the three mediation pathways accounted for 58.55% of the observed relationship. Conclusions This study demonstrated a negative correlation between physical exercise and loneliness among older adults, with frailty and depression serving as significant mediators in this relationship. The findings suggest that physical exercise may alleviate loneliness in older adults by enhancing physiological function and fostering psychosocial empowermen.https://doi.org/10.1186/s12877-025-05988-5Older adultsPhysical exerciseLonelinessFrailtyDepressionMediating role
spellingShingle Song Gu
Shiling Liu
A serial mediation model of physical exercise and loneliness: the role of frailty and depression
BMC Geriatrics
Older adults
Physical exercise
Loneliness
Frailty
Depression
Mediating role
title A serial mediation model of physical exercise and loneliness: the role of frailty and depression
title_full A serial mediation model of physical exercise and loneliness: the role of frailty and depression
title_fullStr A serial mediation model of physical exercise and loneliness: the role of frailty and depression
title_full_unstemmed A serial mediation model of physical exercise and loneliness: the role of frailty and depression
title_short A serial mediation model of physical exercise and loneliness: the role of frailty and depression
title_sort serial mediation model of physical exercise and loneliness the role of frailty and depression
topic Older adults
Physical exercise
Loneliness
Frailty
Depression
Mediating role
url https://doi.org/10.1186/s12877-025-05988-5
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