ArticleJMIR public health and surveillance2023
Community-Level Social Support to Mitigate the Impact of Combined Frailty and Multimorbidity on Psychological Distress Among Rural Chinese Older Adults During the COVID-19 Pandemic: Multilevel Modeling Study.
Article in JMIR public health and surveillance, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 9 citations in OpenAlex.
- Social support and associated factors among community-dwelling older adults in Singapore - a cross-sectional study.BMC geriatrics · 2026Article
- Changes in mental health outcomes of middle-aged and older adults during the COVID-19 pandemic: A scoping review.PloS one · 2026Article
- Social Support's Dual Mechanisms in the Loneliness-Frailty Link Among Older Adults with Diabetes in Beijing: A Cross-Sectional Study of Mediation and Moderation.Healthcare (Basel, Switzerland) · 2025Article
- Relationship Between Perceived Social Support and Physical Frailty Among Older Patients with Coronary Artery Disease: A Dual Mediation Model.Journal of clinical medicine · 2025Article
- The association between continuing work after retirement and the incidence of frailty: evidence from the China health and retirement longitudinal study.The journal of nutrition, health & aging · 2024Article
- Investigating Frailty, Polypharmacy, Malnutrition, Chronic Conditions, and Quality of Life in Older Adults: Large Population-Based Study.JMIR public health and surveillance · 2024Article
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8 authors at 1 institution in 1 country.
Funding
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Abstract
backgroundAccumulating research provides evidence that the psychological health of older people deteriorated from before to during the COVID-19 pandemic. Unlike robust individuals, coexisting frailty and multimorbidity expose older adults to more complicated and wide-ranging stressors. Community-level social support (CSS) is also an important impetus for age-friendly interventions, and it is 1 of the components of social capital that is seen as an ecological-level property. To date, we have not found research that examines whether CSS buffered the adverse impacts of combined frailty and multimorbidity on psychological distress in a rural setting during COVID-19 in China.
objectiveThis study explores the combined effect of frailty and multimorbidity on psychological distress in rural Chinese older adults during the COVID-19 pandemic and examines whether CSS would buffer the aforementioned association.
methodsData used in this study were extracted from 2 waves of the Shandong Rural Elderly Health Cohort (SREHC), and the final analytic sample included 2785 respondents who participated in both baseline and follow-up surveys. Multilevel linear mixed effects models were used to quantify the strength of the longitudinal association between frailty and multimorbidity combinations and psychological distress using 2 waves of data for each participant, and then, cross-level interactions between CSS and combined frailty and multimorbidity were included to test whether CSS would buffer the adverse impact of coexisting frailty and multimorbidity on psychological distress.
resultsFrail older adults with multimorbidity reported the most psychological distress compared to individuals with only 1 or none of the conditions (β=.68, 95% CI 0.60-0.77, P<.001), and baseline coexisting frailty and multimorbidity predicted the most psychological distress during the COVID-19 pandemic (β=.32, 95% CI 0.22-0.43, P<.001). Further, CSS moderated the aforementioned association (β=-.16, 95% CI -0.23 to -0.09, P<.001), and increased CSS buffered the adverse effect of coexisting frailty and multimorbidity on psychological distress during the COVID-19 pandemic (β=-.11, 95% CI -0.22 to -0.01, P=.035).
conclusionsOur findings suggest that more public health and clinical attention should be paid to psychological distress among multimorbid older adults with frailty when facing public health emergencies. This research also suggests that community-level interventions prioritizing social support mechanisms, specifically improving the average levels of social support within communities, may be an effective approach to alleviate psychological distress for rural older adults who concurrently manifest frailty and multimorbidity.
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