School of Political Science and Public Administration, Wuhan University, Wuhan, China.
School of Public Health, Peking University, Beijing, China.
JMIR Public Health Surveill. 2023 Jun 27;9:e44486. doi: 10.2196/44486.
Family health develops from the intersection of the health of each family member and their interactions and capacities as well as the family's internal and external resources. Frailty is the most prominent and typical clinical manifestation during population aging. Family health may be effective in addressing frailty, and this association may be mediated by health literacy and health behaviors. Until now, it is unclear whether and how family health affects frailty in older adults.
This study aimed to examine the associations between family health and frailty and the mediation roles of health literacy and health behaviors.
A total of 3758 participants aged ≥60 years were recruited from a national survey conducted in 2022 in China for this cross-sectional study. Family health was measured using the Short Form of the Family Health Scale. Frailty was measured using the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (FRAIL) scale. Potential mediators included health literacy and health behaviors (not smoking, not having alcohol intake, physical exercise for ≥150 minutes per week, longer sleep duration, and having breakfast every day). Ordered logistic regression was applied to explore the association between family health and frailty status. Mediation analysis based on Sobel tests was used to analyze the indirect effects mediated by health literacy and behaviors, and the Karlson-Holm-Breen method was used to composite the indirect effects.
Ordered logistic regression showed that family health is negatively associated with frailty (odds ratio 0.94, 95% CI 0.93-0.96) with covariates and potential mediators controlled. This association was mediated by health literacy (8.04%), not smoking (1.96%), longer sleep duration (5.74%), and having breakfast every day (10.98%) through the Karlson-Holm-Breen composition.
Family health can be an important intervention target that appears to be negatively linked to frailty in Chinese older adults. Improving family health can be effective in promoting healthier lifestyles; improving health literacy; and delaying, managing, and reversing frailty.
家庭健康源于每个家庭成员的健康及其相互作用和能力，以及家庭的内部和外部资源。衰弱是人口老龄化过程中最突出和典型的临床表现。家庭健康可能对衰弱有效，这种关联可能通过健康素养和健康行为来介导。到目前为止，尚不清楚家庭健康是否以及如何影响老年人的衰弱。
本研究旨在检验家庭健康与衰弱之间的关联，以及健康素养和健康行为的中介作用。
本横断面研究共纳入了 2022 年中国全国性调查中 3758 名≥60 岁的参与者。家庭健康使用家庭健康量表的简短形式进行测量。衰弱使用疲劳、抵抗力、活动能力、疾病和体重减轻（FRAIL）量表进行测量。潜在的中介因素包括健康素养和健康行为（不吸烟、不饮酒、每周进行≥150 分钟的体育锻炼、更长的睡眠时间和每天吃早餐）。有序逻辑回归用于探讨家庭健康与衰弱状况之间的关联。基于 Sobel 检验的中介分析用于分析健康素养和行为介导的间接效应，Karlson-Holm-Breen 方法用于综合间接效应。
有序逻辑回归显示，在控制了协变量和潜在中介因素后，家庭健康与衰弱呈负相关（比值比 0.94，95%CI 0.93-0.96）。这种关联通过健康素养（8.04%）、不吸烟（1.96%）、更长的睡眠时间（5.74%）和每天吃早餐（10.98%）通过 Karlson-Holm-Breen 组成进行中介。
家庭健康可以作为一个重要的干预目标，与中国老年人的衰弱呈负相关。改善家庭健康可以有效促进更健康的生活方式；提高健康素养；以及延缓、管理和逆转衰弱。
