Geriatric Nursing · Oct 26, 2026

The mediating role of depression in the association between social participation and frailty among older adults with PSCI

By Zhao W, Li P, Guo Y et al.

OBJECTIVE: This study aimed to explore the relationships among depressive symptoms, social participation, and frailty in older adults with post-stroke cognitive impairment (PSCI), and to examine the potential mediating role of depressive symptoms in the association between social participation and frailty. METHODS: Convenience sampling was used to recruit older adults with PSCI from a tertiary grade-A hospital in Hebei Province, China, between August and November 2024. A comprehensive survey was conducted using a general information questionnaire, the 5-item Geriatric Depression Scale (GDS-5), the Tilburg Frailty Indicator, and the Impact on Participation and Autonomy questionnaire. Mediation analysis was performed using the PROCESS macro in SPSS, and significance was tested using the Bootstrap method. RESULTS: A total of 262 questionnaires were distributed, of which 6 were excluded because of errors, omissions, or missing data. The final sample consisted of 256 valid questionnaires, yielding an effective response rate of 97.71%. Frailty among older adults with PSCI was positively correlated with depressive symptoms (r = 0.49, P < 0.01) and social participation scores (r = 0.60, P < 0.01). Social participation scores were also positively correlated with depressive symptoms (r = 0.48, P < 0.01). Additionally, depressive symptoms played a significant mediating role in the association between social participation and frailty, accounting for 20.96% of the total effect. CONCLUSION: The findings suggest that social participation is directly and indirectly associated with frailty among older adults with PSCI, with depressive symptoms serving as an important mediating pathway.

doi.org/10.1016/j.gerinurse.2026.104389PubMed 42933139Populations