Social support and subsequent cognitive frailty during a 1-year follow-up of older people: the mediating role of psychological distress

Abstract

Background Frailty and cognitive impairment are two common geriatric symptoms linking adverse health-related outcomes. However, cognitive frailty, a new definition defined by an international consensus group, has been shown to be a better predictor of increased disability, mortality, and other adverse health outcomes among older people than just frailty or cognitive impairment. This study estimated the prospective association between social support and subsequent cognitive frailty over 1 year follow-up, and whether psychological distress mediated the association. Methods The data was drawn from a prospective repeated-measures cohort study on a sample of participants aged 60 and over. A total of 2785 older people who participated in both of the baseline and 1-year follow-up survey were included for the analysis. Cognitive frailty was measured by the coexistence of physical frailty and cognitive impairment without dementia. Control variables included sex, age, education, marital status, economic status, smoking status, alcohol drinking status, chronic conditions, and functional disability. Path analyses with logistic function were performed to examine the direct effects of social support (predictors) on subsequent cognitive frailty (outcome) at 1-year follow-up and the mediating role of psychological distress (mediator) in this link. Results After adjusting for covariates and prior cognitive frailty status, social support was negatively associated with psychological distress (β = − 0.098, 95% CI = − 0.137 to − 0.066, P < 0.001) and was negatively associated with the log-odds of cognitive frailty (β = − 0.040, 95% CI = − 0.064 to − 0.016, P < 0.001). The magnitude of mediation effects from social support to cognitive frailty via psychological distress was a*b = − 0.009, and the ratio of a*b/(a*b + c’) was 24.32%. Conclusions Lower social support is associated with increased rates of subsequent cognitive frailty over 1-year follow-up, and this link is partially mediated through psychological distress, suggesting that assessing and intervening psychological distress and social support may have important implications for preventing cognitive frailty among older people.

Understanding exogenous factors and biological mechanisms for cognitive frailty: a multidisciplinary scoping review

“…In a cross-sectional survey Choi & Ko, (2023) suggested that social factors (social activities, living arrangements, emotional support, etc.) attenuated the association between CF and disability, supporting interventions to improve contact and support, and in longitudinal analyses, Wang et al (2022) found that social support and psychological distress were both associated with CF after one year, social support reducing the negative effect of psychological distress. Rivan et al (2019) also found that lower social support independently predicted CF, alongside depression, age and poorer activities of daily living.…”

Prevalence and modifiable risk factors of cognitive frailty in patients with chronic heart failure in China: a cross-sectional study

“…Loneliness can reflect social support to some extent. However, Wang et al found that psychological distress could regulate the relationship between social support and the prevalence of CF [ 17 ]. Therefore, the relationship between mental state and CF remains vague and requires further study.…”

“…A review shows that social status, nutrition status, physical and cognitive activities and functional status are factors shown to be associated with CF [ 15 ]. However, the effect of depression in CF remains controversial and we need to explore future [ 16 , 17 ]. Social support has been shown to be an influential factor for CF in hypertensive patients [ 18 ] and other studies have found the effects of BMI and nutrition status of CF [ 19 ].…”

Community-Level Social Support to Mitigate the Impact of Combined Frailty and Multimorbidity on Psychological Distress Among Rural Chinese Older Adults During the COVID-19 Pandemic: Multilevel Modeling Study

“…The baseline survey was completed in June 2019, which was considered prior to the COVID-19 pandemic on the basis of the declaration from the World Health Organization on March 11, 2020, that COVID-19 can be characterized as a pandemic [32]. The detailed study design, sampling, and data collection have been described elsewhere [2,33,34]. Briefly, we used the multistage stratified random sampling method to select participants, excluding those who had a clinical diagnosis of dementia or psychiatric diseases, could not complete the interview due to severe physical conditions, or were unwilling to cooperate with the interviewers.…”