Association between frailty and quality of life, and the moderating effect of mobile, broadcast and digital media in sub-Saharan Africa: evidence from Kenya.

Abstract

Background: Globally, frailty is known to negatively impact quality of life, yet this relationship remains underexplored in Kenya. Additionally, there is growing interest in leveraging technology in health and social care to support vulnerable populations, but its potential benefits for older people remain unclear. This study aimed to examine the association between frailty and quality of life, and to explore the moderating role of mobile, broadcast, and digital media in the relationship between frailty and quality of life among older people.

Methods: This study involved 783 older people (aged 60 years and above) who participated in the Health and Well-being of Older Persons in Kenya (HWOPs-1) study. Frailty was assessed using a 32-item Frailty Index, and quality of life was measured using a 7-item index from the World Health Organization's Quality of Life-Brief instrument. Bivariate analysis was conducted to examine associations between frailty, quality of life, and access to mobile, broadcast, and digital media. Multiple moderation regression analysis was used to estimate whether media access (radio, television, mobile phone ownership, and internet usage) influenced the relationship between frailty and quality of life by including interaction terms between frailty and each media variable.

Results: More than half (66.0%) of the study participants were frail, and 82.9% had moderate to good quality of life. Frailty was inversely correlated with quality of life (r = -0.61, p < 0.001), indicating that higher levels of frailty are associated with poorer quality of life. The mobile, broadcast and digital media variables were all positively correlated with frailty (r = 0.121 to 0.330, p < 0.001) and negatively correlated with quality of life (r = -0.24 to -0.12, p < 0.001). The moderation analysis revealed that only mobile phone ownership showed a significant moderation effect (β = 1.10, p = 0.03, 95% CI [0.12, 2.08]), suggesting that access to mobile phones may help mitigate the impact of frailty on quality of life.

Conclusion: Frailty significantly impacts quality of life. Access to mobile phones may help mitigate this effect by fostering social connectedness, while introducing complex technologies may be counterproductive in improving frailty-associated quality of life.