Association between multimorbidity and cognitive frailty among the elderly in China: the mediating effect of

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Jing Lv1, Fengmei Huang2, Yumei Shi2

  • 1West China Hospital Endocrinology and Metabolism Department/West China School of Nursing, Sichuan University, Chengdu 610041, China.

Experimental Gerontology
|August 15, 2025
PubMed

Insights

Older adults with multiple health conditions and depressive symptoms face a higher risk of cognitive frailty. Depressive symptoms significantly mediate the link between multimorbidity and cognitive frailty in the elderly.

Area of Science:

  • Gerontology
  • Public Health
  • Cognitive Science

Background:

  • Cognitive frailty (CF) is a growing concern in aging populations.
  • Understanding the interplay between chronic conditions and mental health is crucial for elderly well-being.

Purpose of the Study:

  • To examine the relationship between multimorbidity, depressive symptoms, and cognitive frailty (CF) in older adults.
  • To investigate the mediating role of depressive symptoms in the association between multimorbidity and CF.

Main Methods:

  • Utilized data from the 2018 China Health and Retirement Longitudinal Study (CHARLS).
  • Included a sample of 9217 elderly individuals (aged ≥60 years).
  • Employed logistic regression and Z-test for mediation analysis to assess associations and mediating effects.

Main Results:

  • Multimorbidity (65.6%) and depressive symptoms (38.7%) were prevalent among participants.
  • Both multimorbidity (OR=2.624) and depressive symptoms (OR=2.737) significantly increased the risk of CF.
  • Depressive symptoms were confirmed as a significant mediator between multimorbidity and CF (Z=2.96, P<0.001).

Conclusions:

  • Cognitive frailty in the elderly is a significant health issue that warrants attention.
  • Multimorbidity and depressive symptoms are independently and collectively associated with increased CF risk.
  • Depressive symptoms play a crucial mediating role in the relationship between multimorbidity and cognitive frailty.
Abstract

Keywords:
Cognitive frailtyDepressive symptomsMediating effectMultimorbidityThe elderly

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