School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, 112, Taiwan R.O.C.
Department of Nursing, Taipei Veteran General Hospital, Taipei, 112, Taiwan R.O.C.
BMC Geriatr. 2023 Mar 27;23(1):176. doi: 10.1186/s12877-023-03873-7.
Maintaining the life satisfaction of frail middle-aged and older adults when they experience physical disability, lower activity status, or complex conditions that are related to each other is now an urgent issue. Therefore, the purpose of this study was to provide evidence for the impact of frailty in middle-aged and older adults on life satisfaction under the simultaneous occurrence and correlation of physical disability and physical activity status.
Data from the 2015 Taiwan Longitudinal Study in Ageing (TLSA) were analyzed by PROCESS in SPSS to explore three different mediation models (N = 4,421). The first was a parallel mediation model for exploring life satisfaction in middle-aged and older adults with frailty through physical disability or physical activity. The second was a serial mediation model for examining physical disability and physical activity in causal chains linked with a specific direction of flow and to test all combinations. The third was a moderated mediation model for testing whether the indirect effect of frailty status on life satisfaction through physical disability or physical activity was moderated by age stratification.
Physical disability and physical activity partially mediated the relationship between frailty status and life satisfaction (IE = -0.196, 95% CI: -0.255 to -0.139). The causal path with the highest indirect effect was found to be that between frailty and physical disability; increased frailty led to higher physical disability, which in turn affected physical activity, leading to lower life satisfaction (IE = 0.013, 95% CI: 0.008 to 0.019). The different stratifications by age significantly increased the mediating effect of physical activity (Index of Moderated Mediation = -0.107, SE = 0.052, 95% CI: -0.208 to -0.005) but did not reduce the mediating effect of physical disability.
This study provides evidence that physical activity and physical disability influence the development of frailty. It also has a significant impact on the life satisfaction of middle-aged and older adults.
当虚弱的中年和老年人经历身体残疾、活动能力下降或与彼此相关的复杂情况时，维持他们的生活满意度是一个紧迫的问题。因此，本研究的目的是提供证据，说明在身体残疾和身体活动状态同时发生和相关的情况下，中年和老年人的虚弱状况对生活满意度的影响。
使用 SPSS 中的 PROCESS 对 2015 年台湾老龄化纵向研究（TLSA）的数据进行分析，以探索三种不同的中介模型（N=4421）。第一种是平行中介模型，用于探索虚弱的中年和老年人通过身体残疾或身体活动实现生活满意度。第二种是序列中介模型，用于检验身体残疾和身体活动在因果链中的联系，并测试所有组合。第三种是调节中介模型，用于检验身体残疾或身体活动对生活满意度的间接影响是否由年龄分层调节。
身体残疾和身体活动部分中介了虚弱状况与生活满意度之间的关系（IE=-0.196，95%CI：-0.255 至-0.139）。发现间接效应最高的因果路径是虚弱与身体残疾之间的关系；虚弱程度增加导致身体残疾程度增加，进而影响身体活动，导致生活满意度降低（IE=0.013，95%CI：0.008 至 0.019）。不同的年龄分层显著增加了身体活动的中介效应（调节中介指数=-0.107，SE=0.052，95%CI：-0.208 至-0.005），但没有降低身体残疾的中介效应。
本研究提供了证据，表明身体活动和身体残疾影响虚弱的发展，并且对中年和老年人的生活满意度有重大影响。
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