Relationship between loneliness and frailty among Chinese community-dwelling older adults: a serial mediation model

Objectives: This study aims to build a serial mediation model by integrating key factors from the existing literature with the cognitive appraisal theory of stress to explore how loneliness could influence frailty. Methods: This is a cross-sectional study. In Hubei Province, China, 600 adults (age >= 60 years old) were recruited from July 1 to December 31, 2023. Information was collected regarding sociodemographic characteristics, loneliness, self-efficacy, physical activity, and frailty. Results: The prevalence of loneliness was 60.8 %, and multidimensional frailty was 38.5 % among Chinese community-dwelling older adults. Additionally, this study found that self-efficacy mediated the effect of loneliness on frailty. However, the mediation effect of physical activity and the serial mediation path was not found. Conclusions: Results suggest that loneliness and frailty in older adults deserve more attention. Interventions focusing on self-efficacy could be considered in the future to improve the frailty of older adults with loneliness. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.