Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 21, 2022
Open Peer Review Period: Nov 21, 2022 - Dec 6, 2022
Date Accepted: May 17, 2023
(closed for review but you can still tweet)
The association between family health and frailty with the mediation role of health literacy and health behavior among older adults in China: a nationwide cross-sectional study
ABSTRACT
Background:
Family health develops from the intersection of the health of each family member, their interactions, capacities, as well as the family’s internal and external resources. It is unclear whether and how family health affects frailty in older adults.
Objective:
The aim of this study is to examine associations between family health and frailty, and the mediation roles of health literacy and health behaviors.
Methods:
A total of 3,865 participants aged ≥60 yeas were selected from a national survey conducted in 2022 in China for this cross-sectional study. Family health was measured using a short form of the family health scale. Frailty was measured using Fried frailty phenotype. Potential mediators included health literacy and health behaviors (smoking, alcohol intake, exercise, sleep duration, and having breakfast every day). Ordered logistic regression was applied to explore the association between family health and frailty status. Mediation analysis were used to analyze the indirect effects mediated by health literacy/behaviors, and the Karlson-Holm-Breen method to composite the indirect effects.
Results:
Ordered logistic regression showed that family health is negatively associated with frailty (OR: 0.95; 95%CI: 0.93-0.96). This association was mediated by health literacy (9.80%), not smoking 2.50%), higher frequency of physical exercise (4.11%), sleep duration (5.21%) and having breakfast every day (9.03%).
Conclusions:
Family health can be an important intervention target that appears to be negatively linked to frailty in Chinese older adults. Improving family health can be effective to promote healthier lifestyles, as well as improve health literacy, and to delay, manage, and reverse frailty.
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