ArticleThe Journal of cardiovascular nursing
Association Between Insomnia and Cognitive Frailty Among Older Patients With Chronic Heart Failure: Multiple Mediating Effects of Depressive Symptoms and Social Support.
Article in The Journal of cardiovascular nursing. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cognitive frailty risk prediction models in patients with chronic kidney disease in China: a systematic review and meta-analysis.BMC nephrology · 2026Pooled it
- Prevalence and Factors Associated with Insomnia Among Chronic Disease Patients in Bangladesh: A Machine Learning Study.Nature and science of sleep · 2025Article
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10 authors.
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Abstract
backgroundOlder patients with chronic heart failure (CHF) are prone to insomnia. Studies have shown that insomnia affects the onset of cognitive frailty and is also strongly associated with depressive symptoms and social support. However, information on how these factors interact to influence cognitive frailty remains underexplored.
objectiveOur aim in this study was to explore the multiple mediating roles of depressive symptoms and social support in the relationship between insomnia and cognitive frailty.
methodsWe recruited 300 hospitalized older patients with CHF to participate in this study. The participants completed the Athens Insomnia Scale, Geriatric Depression Scale, Montreal Cognitive Assessment, FRAIL Scale, and Social Support Rating Scale. The mediation hypothesis was tested using a multiple mediation model and bootstrapping method.
resultsIn this study, 44% of the patients experienced insomnia, and 51.3% were in a state of cognitive frailty. Our main findings suggest that insomnia has an indirect effect on cognitive frailty through 2 pathways: the multiple mediating effects of depressive symptoms and social support, and a single mediating effect of depressive symptoms. The direct effect of insomnia on cognitive frailty is also significant.
conclusionsOlder patients with CHF who experience insomnia tend to have more severe depressive symptoms, cognitive frailty, and poor social support. Thus, interventions to recognize insomnia early, improve depressive symptoms, and provide social support may reduce cognitive frailty in older patients with CHF. Longitudinal studies are necessary to further refine our findings and address the limitations of the current study.
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