Higher Sense of Coherence Is Associated With Lower Frailty Among Community-Dwelling Older Adults: A Cross-Sectional Mediation Study

IntroductionThis cross-sectional study examined the association between sense of coherence and frailty and explored the mediating roles of social support and self-rated health among community-dwelling older adults.MethodsData from 218 older adults were analyzed. Descriptive statistics were used to summarize participant characteristics and study variables, and structural equation modeling with maximum likelihood estimation was performed to test the hypothesized pathways. Indirect effects were evaluated using bias-corrected bootstrap 95% confidence intervals.ResultsSense of coherence exerted a direct negative effect on frailty (β = -0.257, p = 0.005) and an indirect effect through self-rated health, as well as through social support and self-rated health in sequence (β = -0.136, p = 0.001). Although the direct path from social support to frailty was not statistically significant (p = 0.197), social support was indirectly associated with frailty through self-rated health. The final model showed moderate fit (χ²/df = 2.188, SRMR = 0.070, RMSEA = 0.074, CFI = 0.895, TLI = 0.858) and accounted for 35.8% of the variance in frailty.ConclusionThese findings suggest that a higher sense of coherence is associated with a lower level of frailty, partly through psychosocial factors. Further longitudinal and interventional studies are warranted to examine whether interventions targeting sense of coherence, social support, and self-rated health may help mitigate frailty and promote healthy aging.