Mediation effect of depression and health-promoting lifestyle between social isolation and frailty in elderly patients with colorectal cancer in China: A cross-sectional study

Abstract

Purpose

Social isolation can affect frailty in elderly colorectal cancer patients. Despite previous research indicating significant correlations between social isolation, depression, health-promoting lifestyles, and frailty, the mechanisms of interaction remain unclear. The purpose of this study is to investigate the multiple sequential mediating effects of depression and health-promoting lifestyles on the relationship between social isolation and frailty among elderly patients with colorectal cancer.

Methods

A cross-sectional survey was conducted with 280 colorectal cancer patients from a tertiary hospital. Participants completed questionnaires assessing general characteristics, frailty (Tilburg Frailty Scale), social isolation (Lubben Social Network Scale-6), depression (Hospital Depression Scale), and health-promoting lifestyles (Health-Promoting Lifestyle Profile II). Descriptive analysis, correlation, hierarchical multiple regression, and mediation analysis with the PROCESS macro were used.

Results

The results showed that 46.8 % of patients were frail. Depression and health-promoting lifestyles accounted for 31.43 % and 13.63 %, respectively, of the total effect of social isolation on frailty. Additionally, the chain mediation effects of depression and health-promoting lifestyles (4.61 %) were also significant.

Conclusion

This study found that social isolation can directly predict frailty in elderly patients and indirectly predict frailty through the mediating effects of depression and health-promoting lifestyles, as well as the chain mediation effects of depression and health-promoting lifestyles. Therefore, reducing social isolation and improving depression and health-promoting lifestyles in elderly colorectal cancer patients may help prevent the onset of frailty.