ArticleBMC geriatrics2025
A serial mediation model of physical exercise and loneliness: the role of frailty and depression.
Article in BMC geriatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFrailty, depression, and loneliness are significant risk factors that hinder successful aging. Physical exercise has been widely recognized as an effective intervention to improve both the physical and mental health of older adults. Guided by the integral conceptual model of frailty, this study aimed to explore the relationships among physical exercise, frailty, depression, and loneliness, providing theoretical support for designing targeted exercise interventions to alleviate loneliness in older adults.
methodsThis study employed a structural equation model (SEM) and bootstrap method to examine a serial mediation model, investigating the roles of frailty and depression in the relationship between physical exercise and loneliness. A descriptive and cross-sectional design was adopted, and data were collected from 505 older adults aged 60 and above in China between February and July 2023. The data were collected using the Physical Activity Rating Scale (PARS-3), the UCLA Loneliness Scale (ULS-8), the Tilburg Frailty Indicator (TFI) and the Patient Health Questionnaire-9 (PHQ-9).
resultsThe findings revealed a significant direct negative relationship between physical exercise and loneliness (Effect = -0.063, 95% CI: -0.085 to -0.040). Furthermore, frailty and depression were found to mediate this relationship both independently and serially. The independent mediation effect of frailty was - 0.072 (95% CI: -0.090 to -0.055), while the independent mediation effect of depression was - 0.010 (95% CI: -0.019 to -0.003). The serial mediation effect of frailty and depression was - 0.007 (95% CI: -0.011 to -0.002). Collectively, the total indirect effect of the three mediation pathways accounted for 58.55% of the observed relationship.
conclusionsThis study demonstrated a negative correlation between physical exercise and loneliness among older adults, with frailty and depression serving as significant mediators in this relationship. The findings suggest that physical exercise may alleviate loneliness in older adults by enhancing physiological function and fostering psychosocial empowermen.
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