Associations between social support and frailty and the mediating role of mental and physical health: evidence from CHARLS
Mao Li, Yu Tian, Ling Zhang, Lei Fang, Guoying Wang, Jun He, Lijin Lin, Peng Du
Abstract
BACKGROUND: Although studies have demonstrated associations between social support and frailty in older adults, the direction and underlying mechanisms of this relationship are yet to be better delineated. We aimed to investigate the association between different forms of social support and frailty, as well as the mediating role of physical and mental health in this association. METHODS: Participants were adults aged ≥ 60 from the 2011 China Health and Retirement Longitudinal Study (CHARLS). Social support (including formal and informal support), physical health, and mental health were the main variables. Frailty was evaluated using the Physical Frailty Phenotype (PFP) scale, and the relationships among these variables were examined using a structural equation model (SEM). RESULTS: The final analysis included 4,511 participants, with a median age of 66.0 years. And the prevalence of frailty was 7.7%. Frailty was found to be influenced by both formal (β = -0.221, P < 0.001) and informal social support (β = -0.221, P < 0.001). Moreover, formal and informal social support demonstrated positive associations with mental and physical health (β = 0.720, 0.347, 0.679, and 0.484, respectively, all P < 0.001). Mental and physical health were negatively associated with frailty (β = -0.374, -0.202, respectively, both P < 0.001). CONCLUSIONS: The relationship between social support and frailty appears to be mediated by mental and physical health, primarily through psychological pathways. Therefore, comprehensive interventions aimed at improving social support and mental and physical health are recommended to prevent frailty.