A Studty On The Relationship And Mediating Effect Between Cognitive Frailty And Fear Of Falling Among The Elderly In The Community

Objective:Through the investigation to understand community cognitive frailty in the elderly,social support and loneliness and fell fear the status quo,and to analyze its influencing factors,to explore the relationship between cognitive frailty and fall of fear in the elderly,the analysis of social support and loneliness in the correlation between the intermediary effect,to improve the elderly fall fear make corresponding intervention measures provides basis and guidance.Methods:Convenience sampling was used to select the elderly in the community of Kaifeng City,Henan Province as the survey object.A total of 320 elderly people who met the admission and discharge standards were investigated,and 306 valid questionnaires were recovered.The questionnaire includes 6 parts: general information(age,gender,marital status,education level,living status,average monthly income),living habits(smoking history,drinking history,sleep status,chronic disease history,fall history,subjective cognition)functional decline),cognitive decline,social support,loneliness,and fear of falling.SPSS.26 software and macro program Process were used to conduct statistical analysis on the data: use mean ±standard deviation,frequency,composition ratio,etc.to describe the general information and living habits of the elderly in the community;use chi-square test,t test and one-way variance Univariate analysis was performed;Pearson & Spearman correlation analysis was used to explore the relationship between cognitive weakness,social support,loneliness and fear of falling;Logistic regression or multiple linear regression were used for multivariate analysis.On the basis of multivariate analysis,a chain mediation effect model was constructed to analyze the relationship between cognitive weakness and fear of falling,as well as the role of social support and loneliness between them.Result:1.Descriptive analysis: A total of 306 subjects were included in this study,27.8% of the elderly in the community had cognitive frailty,54.9% had fear of falling;the total score of social support was(35.24±6.87)points;the overall score of loneliness was(10.96±3.09)points;the overall score of fear of falling was(10.06±3.79)points.2.Univariate analysis: Cognitive frailty of the elderly in the community was affected by age,marital status,living status,sleep status,history of chronic diseases,history of falling and subjective cognitive decline(P < 0.05);The effects of age,marital status,education level,average monthly income,sleep status,history of chronic diseases,history of falls and decline in subjective cognitive function(P < 0.05).3.Correlation analysis: There was a significant negative correlation between cognitive frailty and social support among the elderly in the community,a significant positive correlation between cognitive frailty and loneliness,a significant positive correlation between cognitive frailty and fear of falling,and a significant negative correlation between social support and loneliness.Correlation,social support was significantly negatively correlated with fear of falling,and loneliness was significantly positively correlated with fear of falling.4.Multivariate analysis: Age,marital status and history of falls are the influencing factors of cognitive frailty in the elderly in the community(P < 0.05);while cognitive weakness,social support,loneliness and history of falls are the fear of falls among the elderly in the community influencing factors(P < 0.05).5.Mediating effect analysis: Cognitive weakness has a significant direct effect on the fear of falling.Social support and loneliness can play a partial mediating effect in the prediction of cognitive weakness on the fear of falling.Social support can also affect loneliness in cognitive weakness.A chain-mediated mediating effect is exerted in the prediction of fear of falling.The mediating effect of social support between cognitive weakness and fear of falling was 0.23,and the Bootstrap 95% CI was(0.15-0.33),accounting for 24.47% of the total effect;the mediating effect of loneliness was 0.24,and the Bootstrap95% CI was(0.08-0.41),accounting for 25.53% of the total effect;the chain mediating effect between social support and loneliness was 0.12,and the Bootstrap 95% CI was(0.07-0.19),accounting for 12.77%of the total effect.Conclusion:In this study,the incidence of cognitive frailty,social support,loneliness and fear of falling in the elderly in the community were all at moderate levels,and there was a significant correlation between each variable.In addition,the fear of falling among the elderly in the community is affected by multiple factors,and cognitive frailty can indirectly affect the fear of falling through social support or loneliness as a mediating variable,and can also affect the fear of falling through the chain mediating effect of social support and loneliness.Therefore,interventions on the fear of falls in the elderly can be considered from the perspective of social support and loneliness,and scientific interventions can be developed to improve the level of fear of falls in the elderly..