Frailty, depression, and quality of life in acute care for elderly: a serial mediation and moderated mediation study in Taiwan

Clicks: 4
ID: 327047
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #112 of 114 articles by views in International journal for quality in health care : journal of the International Society for Quality in Health Care

Most read Least read

Bar heights use a square-root scale.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
BACKGROUND: Although the acute care for the elderly (ACE) model has been studied in relation to activities of daily living (ADL), depressive symptoms, and quality of life, the pathways linking frailty with post-discharge quality of life remain insufficiently understood. This study examined whether ADL and depressive symptoms sequentially mediated the association between frailty and quality of life among elderly patients receiving acute care. METHODS: This retrospective cohort study with longitudinal follow-up included 11,231 elderly acute care patients from three large medical centers in Taiwan between January 1, 2020, and June 30, 2023. Frailty, ADL, depressive symptoms, and quality of life were assessed at admission and one year after discharge using the Clinical Frailty Scale, ADL scale, Geriatric Depression Scale, and EQ-5D-3L. Serial mediation and moderated mediation analyses were conducted using the PROCESS macro in SPSS version 23.0. RESULTS: One-year ADL and depressive symptoms sequentially mediated the association between admission frailty and one-year quality of life (indirect effect = 0.131, 95% CI 0.038∼0.231). Frailty scores significantly decreased and ADL scores improved from admission to one year after discharge (p < 0.05). Moderated mediation analyses showed that BMI, Charlson Comorbidity Index, alcohol use, nasogastric tube placement, and nutritional status modified specific mediation pathways (p < 0.001). CONCLUSION: Frailty among elderly patients receiving acute care was associated with post-discharge quality of life through pathways involving ADL and depressive symptoms. It supports comprehensive assessment and early post-discharge interventions targeting functional and psychological well-being, while recognizing that causal relationships cannot be established from observational data.
Reference Key
openalex_W7204936785 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Chau-Nee Chen, Tzu-Jung Fang, Cheng‐Fang Hsieh, Chun-Chang Chen, Yu-Fu Chen, Hong-Yaw Chen, Pin-Yu Lai, Yu-Han Lu, Hon-Yi Shi
Journal International journal for quality in health care : journal of the International Society for Quality in Health Care
Year 2026
DOI
10.1093/intqhc/mzag122
URL
https://doi.org/10.1093/intqhc/mzag122
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.