The relationship between cognitive impairment and quality of life in rural older adults with chronic diseases-parallel mediating effects of depressive symptoms and frailty.

ABSTRACT:

Background

Cognitive impairment among older adults is a significant public health concern worldwide. Although previous studies have demonstrated that cognitive impairment impacts the quality of life in these patients, the mechanism between these two variables is still unclear. This study endeavors to investigate the parallel mediating roles of depressive symptoms and frailty on cognitive impairment and quality of life in rural older adults with chronic diseases.

Methods

This study used data from a cross-sectional study conducted in rural areas of China from October 2024 to January 2025. A total of 2,697 rural older adults With chronic diseases were included. All data were analyzed using SPSS 26.0 software. Spearman correlation analysis Was used to investigate the relationships between variables. Model 4 from the SPSS macro was used to assess the parallel mediating roles of depressive symptoms and frailty in the relationship between cognitive impairment and quality of life among rural older adults with chronic diseases.

Results

Cognitive impairment, depressive symptoms, and frailty were significantly associated with quality of life in rural older adults with chronic diseases (p < 0.01). Cognitive impairment was a negative predictor of quality of life (β = -0.2300, p < 0.001). Cognitive impairment was a positive predictor of depressive symptoms (β = 0.2881, p < 0.001) and frailty (β = 0.2275, p < 0.001). Cognitive impairment (β = -0.0964, p < 0.001), depressive symptoms (β = -0.2144, p < 0.001), and frailty (β = -0.3157, p < 0.001) were negative predictors of quality of Life. Cognitive impairment influenced quality of Life through parallel mediating effects of depressive symptoms and frailty, With mediating effects accounting for 26.85% and 31.48% of the total effect, respectively.

Conclusions

We found that cognitive impairment not only directly affects the quality of life of rural older adults with chronic diseases but also indirectly affects them through depressive symptoms and frailty. To improve the quality of life of rural older adults with chronic diseases, we should pay attention to their cognitive impairment. Simultaneously, efforts should focus on alleviating depressive symptoms and frailty in this population. Strengthening the management of chronic diseases is also essential. These steps will help us achieve the goal of healthy aging.

SUBMITTER: Li H 

PROVIDER: S-EPMC12482007 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature