Social frailty and physical resilience in elderly patients with motor cognitive risk syndrome: the multiple mediation effect of aging anxiety and fall alertness

Background Successful aging is a positive state of aging. Physical resilience, as a predictive indicator of future health and lifespan in the elderly, is a key entry point for them to achieve the goal of successful aging. Therefore, to promote successful aging among the elderly population, this study aimed to explore the sequential multiple mediating effects of aging anxiety and fall alertness between social frailty and physical resilience in elderly patients with motor cognitive risk syndrome(MCR). Methods A questionnaire survey was conducted among 800 elderly patients aged 65 and above with MCR from 11 Class-A grade-3 general hospitals in Shaanxi, Shanxi, Hunan, and Guangdong Provinces, China, using convenience sampling. The Anxiety about Aging Scale (AAS), the Self-Awareness of Falls in Elderly scale (SAFE), the Social Frailty Scale 8-item (SFS-8), and the Physical Resilience Instrument for Older Adults (PRIFOR) were used to measure the variables. Sequential multiple mediating analysis was conducted using the SPSS macro PROCESS 4.0 to evaluate the potential mediating roles of aging anxiety and fall alertness. Results Social frailty, aging anxiety, fall alertness, and physical resilience were significantly correlated( P  < 0.01). Social frailty was not only directly related to the physical resilience of elderly patients with MCR(effect =-0.526;Standard error = 0.094; 95%CI: LL=-0.711, UL=-0.34), and also through the independent mediating effect of aging anxiety (effect =-0.285; Standard error = 0.042; 95%CI:LL=-0.371, UL=-0.206), the independent mediating effect of fall alertness (effect=-0.091;Standard error = 0.025;95%CI:LL=-0.145,UL=-0.047), the chain mediating effect between aging anxiety and fall alertness (effect=-0.094;Standard error = 0.019; 95%CI:LL=-0.134,UL=-0.058) was associated with physical resilience. Conclusions Studies have shown that the aging anxiety and fall alertness of elderly patients with MCR in China can mediate the connection between social frailty and physical resiliency. This suggests that it may become a key target for future intervention measures aimed at enhancing the physical resilience of the elderly and promoting successful aging. Clinical trial number: Not applicable.