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ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1527982
This article is part of the Research TopicInnovations and Strategies for Comprehensive Frailty Management in Older PeopleView all 5 articles
The association between multimorbidity patterns and physical frailty among middle-aged and older community-dwelling adults: The mediating role of depressive symptoms
Provisionally accepted
Yuhan Geng1,2Ming Zhou1,2
Yangxiaoxue Liu2Tianshu Zhao2Jiali Zhang2Min Xin2Wenxin Wang2
Gongzi Zhang2*
Liping Huang2*- 1People's Liberation Army General Hospital, Beijing, China
- 2The first medical center, Chinese PLA General hospital, Beijing, China
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Background: This study aimed to investigate the association between multimorbidity and frailty, and the potential mediating role of depressive symptoms in Chinese middle-aged and older community-dwelling adults.We selected a total of 5232 adults with two or more chronic diseases from the China Health and Retirement Longitudinal Study (CHARLS) database. Clusters of participants with similar multimorbidity patterns were identified through fuzzy c-means cluster analyses. The cross-sectional association between multimorbidity and frailty was measured through logistic regression analyses. Mediation analysis was applied to examine direct and indirect associations within the counterfactual framework.Results: At baseline, we identified five multimorbidity patterns. Two of these patterns significantly increased the risk of frailty compared to a non-specific pattern. Depression mediated 35.20% of the effect of multimorbidity on frailty (p = 0.042). Notably, in adults aged 60 years and older, this mediation accounted for 69.84% of the total effect, surpassing the direct impact of multimorbidity on frailty. Among individuals with economic support (0.020, 95% CI: 0.002-0.040), high school education (0.062, 95% CI: 0.007-0.120), and no alcohol consumption (0.024, 95% CI: 0.003-0.050), depression entirely mediated the impact of comorbidities.This study reveals strong links between specific multimorbidity patterns and physical frailty, with depression significantly mediating these effects, particularly in certain populations. Findings emphasize tailored mental health interventions' necessity in specific groups.
Keywords: not application Multimorbidity, Frailty, depressive symptoms, Cluster analysis, Mediation analysis Cerebrovasc.,Resp. & Hepatic Cerebrovascular disease , Disease of Respiratory system & Hepatic disease Psychiatric & Cerebrovasc. Psychiatric & Cerebrovascular disease Memory& Metabolic Memory Related Disease & Metabolic
Received: 14 Nov 2024; Accepted: 14 Apr 2025.
Copyright: © 2025 Geng, Zhou, Liu, Zhao, Zhang, Xin, Wang, Zhang and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Gongzi Zhang, The first medical center, Chinese PLA General hospital, Beijing, China
Liping Huang, The first medical center, Chinese PLA General hospital, Beijing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.