Physical frailty and health-related quality of life among Chinese rural older adults: a moderated mediation analysis of physical disability and physical activity

Abstract

ObjectivesThe purpose of this study is to explore the mediating effect of physical disability as well as the role of physical activity (PA) as a moderator in the relationship between physical frailty and health-related quality of life (HRQoL) among rural older adults in China.DesignCross-sectional analysis.SettingRural households in Shandong of China (Rushan, Qufu, Laolin).Participants and methodsA survey was conducted among 3243 rural older adults. The data were collected using questionnaires measuring physical frailty, physical disability, HRQoL and PA. Bootstrap analyses were employed to explore the mediating effect of physical disability and also the moderating role of PA on physical frailty and HRQoL.ResultsAfter controlling for age and education, physical disability partially mediated the effect of physical frailty on HRQoL (indirect effect=−0.143, 95% CI −0.175 to –0.113), with the mediating effect accounting for 33.71% of the total effect. PA moderated the relationship between physical frailty and physical disability as well as the relationship between physical disability and HRQoL. Specifically, the interaction term between physical frailty and PA significantly predicted physical disability (β=−0.120, t=−7.058, p<0.001), and the interaction term between physical disability and PA also had a significant predictive effect on HRQoL (β=0.115, t=6.104, p<0.001).ConclusionsPA appears to moderate the indirect effect of physical disability on the association between physical frailty and HRQoL. This study provides support for potential mechanisms in the association between physical frailty and HRQoL. Encouraging rural older adults to increase PA appropriately might improve HRQoL for older adults with physical frailty and physical disability problems.

Exploring the Mediating Effects of Cognitive Function, Social Support, Activities of Daily Living and Depression in the Relationship between Age and Frailty among Community-Dwelling Elderly

“…Our results were compatible with previous findings from many studies, where the process of aging is a risk factor for frailty, cognition, and psychosocial function [ 29 ]. In addition, we found that the effect of age on frailty was partially mediated by ADL, and this result corresponded to Hao’s study where poor ADL partially and indirectly leads to frailty [ 30 ]. This result was also supported by another study showing exercise interventions could alleviate frailty in older adults [ 31 ].…”

Classifying and characterizing the development of self-reported overall quality of life among the Chinese elderly: a twelve-year longitudinal study

“…One possible explanation was that disabled older adults’ self-care ability deteriorated and then their normal physiological activities were restricted. Such a process affected their social interaction and mental health adversely, and this reduced their perception of QoL ultimately [ 49 ]. Besides, physical health was a strong predictor of psychological well-being which was closely connected with the perception of QoL among the elderly [ 50 ].…”

The Role of Mental Adjustment in Mediating Post-Traumatic Stress Disorder Symptoms and Social Support in Chinese Ovarian Cancer Patients: A Cross-Sectional Study

“…The SPSS PROCESS macro 3.5 with 5000 bootstrap samplings was adopted to examine the role of mental adjustment in mediating social support and PTSD symptoms. [35][36][37] The specific indirect effect is calculated by a * b product. If zero is not included in the bias-corrected and accelerated 95% CI (BCa 95% CI), the role in mediation is statistically significant.…”