Social Frailty and Functional Status in Japanese Older Adults: The Mediating Role of Subjective Cognitive Function

Mingyu Cui; Dandan Jiao; Kumi Watanabe Miura; Yang Liu; Xiang Li; Zhu Zhu; Yuko Sawada; Taeko Watanabe; Emiko Tanaka; Tokie Anme

doi:10.1016/j.jamda.2024.02.009

Social Frailty and Functional Status in Japanese Older Adults: The Mediating Role of Subjective Cognitive Function

J Am Med Dir Assoc. 2024 Mar 24:104971. doi: 10.1016/j.jamda.2024.02.009. Online ahead of print.

Authors

Mingyu Cui¹, Dandan Jiao², Kumi Watanabe Miura³, Yang Liu¹, Xiang Li¹, Zhu Zhu¹, Yuko Sawada⁴, Taeko Watanabe⁵, Emiko Tanaka⁶, Tokie Anme⁷

Affiliations

¹ School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Japan.
² School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Japan; Department of Nursing, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang City, Henan Province, China.
³ RIKEN, Center for Advanced Intelligence Project, Nihonbashi, Tokyo, Japan.
⁴ Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka, Japan.
⁵ Faculty of Nursing, Shukutoku University, Chiba, Japan.
⁶ Faculty of Nursing, Musashino University, Tokyo, Japan.
⁷ Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. Electronic address: tokieanme@gmail.com.

PMID: 38537667
DOI: 10.1016/j.jamda.2024.02.009

Abstract

Objective: This study aimed to explore the direct and indirect effects of social frailty on functional state trajectories mediated by subjective cognitive function in older adults.

Design: Longitudinal study.

Setting and participants: Overall, 514 adults aged ≥65 years living in a suburban area of central Japan were included in this study.

Methods: Five-item social frailty index (going out, visiting, feeling helpful, living alone, and talking to others), subjective cognitive function from the Kihon Checklist, and instrumental activities of daily living disability. Latent growth curve models were applied to examine the longitudinal relations among the variables.

Results: During the 6-year follow-up in latent growth curve models, the initial level of social frailty in older adults was negatively associated with that of functional status (β = -0.53, P < .001), and the rate of change in social frailty was negatively associated with that in functional status (β = -0.78, P < .001). In the mediation model, the indirect effect from the social frailty level to functional status level through subjective cognitive function level was significant (β = -0.14, 95% CI -0.29, -0.09); the rates of change in subjective cognitive function mediated the relationship between those in social frailty and functional status (β = -0.35, 95% CI -0.46, -0.25).

Conclusions and implications: This study found that there is an association between social frailty and functional status in Japanese older adults. Subjective cognitive function mediated this relationship. Hence, additional research is required to investigate additional potential factors linking social frailty and functional status in order to gain a better understanding of the underlying mechanisms.

Keywords: Older adults; cognitive impairment; disability; social frailty.