Fang Xueying, Deng Minghui, Zhang Wenjuan, Wang Liyan, Wang Hejie, Xu Pengkai, Luo Yanyan, Yao Guiying
School of Nursing, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, Henan, 453003, China.
Xinxiang Key Laboratory for Chronic Disease Basic Research and Intelligent Care, Xinxiang, Henan, 453003, PR China.
BMC Geriatr. 2024 Dec 2;24(1):985. doi: 10.1186/s12877-024-05577-y.
With the global population aging rapidly, understanding the factors influencing health outcomes in older adults is crucial. This study explores the longitudinal causal relationship between self-perceptions of aging and frailty and examines whether subjective cognitive decline mediated the associations.
The Brief-Aging Perceptions Questionnaire(B-APQ), the Frailty Phenotype Assessment Scale, and the Subjective Cognitive Decline Questionnaire were used to survey 619 community-dwelling older adults in Xinxiang, Henan, China, from March to October 2021 and from March to October 2023, respectively. A cross-lagged model was employed to analyze the potential mediating roles of subjective cognitive decline, controlling for confounders including age, gender, income, employment status, and education.
(1) The cross-lagged model analysis revealed a bidirectional causal relationship between self-perceptions of aging and frailty (P < 0.001), with the effect of T1 self-perceptions of aging on T2 frailty (β = 0.109, SE = 0.038, P < 0.01) and the reverse effect (β = 0.129, SE = 0.041, P < 0.01). Further comparisons of the path coefficients indicated that the effect sizes of the two paths showed no statistical difference (χ = 0.119, P > 0.05). (2) The longitudinal mediation analysis indicated that T1 self-perceptions of aging had an indirect effect on T2 frailty through subjective cognitive decline (indirect effect = 0.011). Concurrently, T1 frailty also indirectly influenced T2 self-perceptions of aging via subjective cognitive decline (indirect effect = 0.010), with all effects demonstrating statistical significance (P < 0.05).
This study demonstrates a bidirectional causal relationship between self-perceptions of aging and frailty, with subjective cognitive decline identified as a mediating mechanism. These findings provide important guidance for future efforts aimed at reducing frailty rates among older adults in community settings.
随着全球人口迅速老龄化，了解影响老年人健康结局的因素至关重要。本研究探讨衰老自我认知与衰弱之间的纵向因果关系，并检验主观认知衰退是否介导了这种关联。
分别于2021年3月至10月以及2023年3月至10月，使用简短衰老认知问卷（B-APQ）、衰弱表型评估量表和主观认知衰退问卷，对中国河南省新乡市619名社区居住老年人进行调查。采用交叉滞后模型分析主观认知衰退的潜在中介作用，同时控制年龄、性别、收入、就业状况和教育程度等混杂因素。
（1）交叉滞后模型分析显示衰老自我认知与衰弱之间存在双向因果关系（P < 0.001），T1期衰老自我认知对T2期衰弱的效应（β = 0.109，标准误 = 0.038，P < 0.01）以及反向效应（β = 0.129，标准误 = 0.041，P < 0.01）。路径系数的进一步比较表明，两条路径的效应大小无统计学差异（χ = 0.119，P > 0.05）。（2）纵向中介分析表明，T1期衰老自我认知通过主观认知衰退对T2期衰弱有间接效应（间接效应 = 0.011）。同时，T1期衰弱也通过主观认知衰退间接影响T2期衰老自我认知（间接效应 = 0.010），所有效应均具有统计学意义（P < 0.05）。
本研究证明了衰老自我认知与衰弱之间存在双向因果关系，主观认知衰退被确定为一种中介机制。这些发现为未来旨在降低社区老年人衰弱率的工作提供了重要指导。
