Mediating effect of social participation in the association between cognitive frailty and health-related quality of life among hospitalized older adults: a cross-sectional study in Xi’an, China
Bibliographic record
Abstract
BACKGROUND: Cognitive frailty, the co-occurrence of physical frailty and cognitive impairment, has emerged as an essential factor affecting the health-related quality of life (HRQoL) among older adults; however, the role of social participation remains unknown. Our study aimed to explore the mediating role of social participation in the association between cognitive frailty and HRQoL among hospitalized older adults. METHODS: A total of 467 older adults were recruited from three tertiary hospitals in Xi'an, China. Cognitive frailty was ascertained by the FRAIL scale and the Montreal Cognitive Assessment. Social participation was assessed by the questionnaire that was developed based on the China Health and Retirement Longitudinal Study. HRQoL was measured by the 36-item Short Form Health Survey. Bootstrap mediation effects were employed to estimate the mediating effect of social participation in the association between cognitive frailty and HRQoL. RESULTS: The average age of the participants was 70.8 years and 51.8% were female. Individuals with cognitive frailty had significantly lower levels of social participation (5.9 ± 3.7 vs. 7.8 ± 4.1) and HRQoL (57.8 ± 15.5 vs. 68.1 ± 13.9) (physical component summary [PCS]: 52.4 ± 19.0 vs. 66.0 ± 16.7; mental component summary [MCS]: 63.2 ± 16.5 vs. 70.2 ± 15.4) compared to those without cognitive frailty. Social participation partially mediated the association between cognitive frailty and HRQoL (average causal mediation effect [ACME] = -1.22, 95% confidence interval [CI]: - 2.20, -0.51) as well as on its dimensions of PCS (ACME = -1.12, 95% CI: - 2.13, - 0.55) and MCS (ACME = -1.29, 95% CI: - 2.35, - 0.49). Gender moderated the mediating effect of social participation in the association between cognitive frailty and HRQoL, which was more pronounced in women than that in men. CONCLUSIONS: The findings suggest that social participation mediates the association between cognitive frailty and HRQoL, particularly for women. This study expands the current literature on designing policy solutions to promote participation in social activities among older adults with cognitive frailty, with the goal of maintaining their HRQoL at a favorable level.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".