Moderating effect of IADL on the relationship between depression and loneliness in cognitive frailty people

Background: Identification of depression and loneliness among people with cognitive frailty could prevent negative psychological and physical health outcomes. Few studies have focused on physical and mental health together among people with cognitive frailty, little is known about the role of daily activity in the association between depression and loneliness among elderly individuals with cognitive frailty. Objectives: To determine the direct effect of loneliness on depression among community-dwelling older adults with cognitive frailty as well as the moderating effect of daily activity. Design, setting, participants, and measurements: This cross-sectional study included 529 adults aged 65 years and older from community-dwelling population who were screened for cognitive frailty, and was conducted from July 2023 to December 2023. The participants were assessed using validation instruments for measuring main variables: Short-form Geriatric Depression Scale, loneliness questionnaire, Athens Insomnia Scale, Instrumental Activities of Daily Living (IADL), Social Support Scale, and sociodemographic characteristics. Results The IADL, depression, insomnia, and loneliness scores were lower among individuals with frailty than among individuals with prefrailty. The interaction effect of IADL* loneliness illustrated that the moderating effect of IADL on the relationship between loneliness and depression significantly differed based on the IADL score. When IADL scores were low, the impact of loneliness on depression was more significant. Conclusions The integrity of physical and social connections has a protective effect on the mental health of elderly with cognitive frailty. It is necessary to pay attention to disability and loneliness among elderly individuals. Targeted interventions for improving physical activity and social participation seem to be practical and feasible solutions to alleviate depressive symptoms.