The Impact of Social Participation on Frailty among Older Adults: The Mediating Role of Loneliness and Sleep Quality

Background: Frailty has become a common health issue among older adults, imposing a burden on both society and individuals. The relationship between social participation and frailty has received widespread attention, but the mechanism remains to be explored. The aim of this study is to explore the impact of social participation on frailty among older adults and to analyze the mediating role of loneliness and sleep quality, providing suggestions to alleviate frailty. Methods: Data related to social participation, loneliness, sleep quality, and frailty from 7779 older adults were collected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 2018). The chain mediation model was conducted to explore the relationship between variables, and the Bootstrap method was used to examine the path coefficients. Results: Social participation negatively affected frailty (beta = -0.00391049, 95% CI = [-0.042296, -0.035465]); the indirect effect of social participation on frailty mediated by loneliness was -0.0019505 (95% CI = [-0.002551, -0.001371]); the indirect effect of social participation on frailty mediated by sleep quality was -0.0011104 (95%CI = [-0.001692, -0.000557]); the effect mediated by both loneliness and sleep quality was -0.0004263 (95% CI = [-0.000593, -0.000304]). Conclusions: Social participation negatively affected frailty. Loneliness and sleep quality not only mediated independently, but also played a chain mediating role. This suggested that encouraging older adults to engage in more social participation, reducing loneliness, and improving sleep quality are feasible measures to improve frailty.