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A moderated mediation analysis of depression and age on the relationship between resilience and frailty among HIV-positive adults

BACKGROUND: Given the continuing challenges frailty poses among people living with human immunodeficiency virus (HIV) (PLHIV), accumulating evidence suggests that frailty is linked to psychological factors. However, the mutual influences of resilience, depression, and frailty have not yet been clari...

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Autores principales: Meng, Lijun, Chen, Dan, Hu, Peiwu, Yao, Meng, Zhou, Cui, Li, Xingli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077968/
https://www.ncbi.nlm.nih.gov/pubmed/37033029
http://dx.doi.org/10.3389/fpubh.2023.1128309
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author Meng, Lijun
Chen, Dan
Hu, Peiwu
Yao, Meng
Zhou, Cui
Li, Xingli
author_facet Meng, Lijun
Chen, Dan
Hu, Peiwu
Yao, Meng
Zhou, Cui
Li, Xingli
author_sort Meng, Lijun
collection PubMed
description BACKGROUND: Given the continuing challenges frailty poses among people living with human immunodeficiency virus (HIV) (PLHIV), accumulating evidence suggests that frailty is linked to psychological factors. However, the mutual influences of resilience, depression, and frailty have not yet been clarified. This study aimed to identify the potential mechanistic pathway through which psychological factors mitigate frailty. METHODS: Data were collected from June to August 2019 by trained investigators through face-to-face interviews with 375 HIV-positive Chinese adults. Each participant completed structured questionnaires to collect data in respect of their socio-demographic characteristics, and levels of frailty, depression, and resilience. These assessment measures included a self-designed questionnaire, the Tilburg Frailty Indicator (TFI), the 10-item Center for Epidemiological Studies Depression Scale (CES-D-10), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). SPSS PROCESS macro was used to analyze the mediation and moderated mediation models. RESULTS: The overall prevalence of frailty was 26.4%, and the prevalence of frailty among older and younger adults living with HIV was 22 and 31.4%, respectively. Mediation analysis showed that an association between resilience and frailty was mediated by depression, whereas resilience did not mediate the relationship between depression and frailty. Compared to physical frailty, depression was a stronger mediator of resilience to psychological frailty. We further found that age moderated the indirect effect of resilience on psychological frailty, with resilience being a stronger negative predictor of depression and depression being a stronger positive predictor of psychological frailty for older PLHIV than for younger PLHIV. CONCLUSION: Lower levels of resilience and greater levels of depression may be significant risk factors for frailty among PLHIV. Levels of resilience influenced frailty directly and frailty was indirectly affected by depression. Therefore, it is recommended that PLHIV, especially older patients, should be encouraged to establish positive psychological coping strategies to slow the progression of frailty.
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spelling pubmed-100779682023-04-07 A moderated mediation analysis of depression and age on the relationship between resilience and frailty among HIV-positive adults Meng, Lijun Chen, Dan Hu, Peiwu Yao, Meng Zhou, Cui Li, Xingli Front Public Health Public Health BACKGROUND: Given the continuing challenges frailty poses among people living with human immunodeficiency virus (HIV) (PLHIV), accumulating evidence suggests that frailty is linked to psychological factors. However, the mutual influences of resilience, depression, and frailty have not yet been clarified. This study aimed to identify the potential mechanistic pathway through which psychological factors mitigate frailty. METHODS: Data were collected from June to August 2019 by trained investigators through face-to-face interviews with 375 HIV-positive Chinese adults. Each participant completed structured questionnaires to collect data in respect of their socio-demographic characteristics, and levels of frailty, depression, and resilience. These assessment measures included a self-designed questionnaire, the Tilburg Frailty Indicator (TFI), the 10-item Center for Epidemiological Studies Depression Scale (CES-D-10), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). SPSS PROCESS macro was used to analyze the mediation and moderated mediation models. RESULTS: The overall prevalence of frailty was 26.4%, and the prevalence of frailty among older and younger adults living with HIV was 22 and 31.4%, respectively. Mediation analysis showed that an association between resilience and frailty was mediated by depression, whereas resilience did not mediate the relationship between depression and frailty. Compared to physical frailty, depression was a stronger mediator of resilience to psychological frailty. We further found that age moderated the indirect effect of resilience on psychological frailty, with resilience being a stronger negative predictor of depression and depression being a stronger positive predictor of psychological frailty for older PLHIV than for younger PLHIV. CONCLUSION: Lower levels of resilience and greater levels of depression may be significant risk factors for frailty among PLHIV. Levels of resilience influenced frailty directly and frailty was indirectly affected by depression. Therefore, it is recommended that PLHIV, especially older patients, should be encouraged to establish positive psychological coping strategies to slow the progression of frailty. Frontiers Media S.A. 2023-03-23 /pmc/articles/PMC10077968/ /pubmed/37033029 http://dx.doi.org/10.3389/fpubh.2023.1128309 Text en Copyright © 2023 Meng, Chen, Hu, Yao, Zhou and Li. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Meng, Lijun
Chen, Dan
Hu, Peiwu
Yao, Meng
Zhou, Cui
Li, Xingli
A moderated mediation analysis of depression and age on the relationship between resilience and frailty among HIV-positive adults
title A moderated mediation analysis of depression and age on the relationship between resilience and frailty among HIV-positive adults
title_full A moderated mediation analysis of depression and age on the relationship between resilience and frailty among HIV-positive adults
title_fullStr A moderated mediation analysis of depression and age on the relationship between resilience and frailty among HIV-positive adults
title_full_unstemmed A moderated mediation analysis of depression and age on the relationship between resilience and frailty among HIV-positive adults
title_short A moderated mediation analysis of depression and age on the relationship between resilience and frailty among HIV-positive adults
title_sort moderated mediation analysis of depression and age on the relationship between resilience and frailty among hiv-positive adults
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077968/
https://www.ncbi.nlm.nih.gov/pubmed/37033029
http://dx.doi.org/10.3389/fpubh.2023.1128309
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