{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T14:03:55Z","timestamp":1781013835487,"version":"3.54.1"},"reference-count":52,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003093","name":"Ministry of Higher Education, Malaysia","doi-asserted-by":"publisher","award":["LRGS\/1\/2019\/UM\/01\/1\/2"],"award-info":[{"award-number":["LRGS\/1\/2019\/UM\/01\/1\/2"]}],"id":[{"id":"10.13039\/501100003093","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychogeriatrics"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The relationship between chronic conditions and depressive symptoms in ageing populations is complex and influenced by various factors. This study aimed to examine the mediating role of self\u2010rated health and the moderating role of social frailty in the relationship between chronic conditions and depressive symptoms among community\u2010dwelling middle\u2010aged and older adults in Malaysia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional study analyzed baseline data from the AGELESS study, comprising 1675 community\u2010dwelling adults aged 56\u201397\u2009years (mean age 72.4\u2009years) in Malaysia. Depressive symptoms were measured using the 15\u2010item Geriatric Depression Scale. Chronic conditions were assessed based on self\u2010reported diagnoses of 17 specific health issues. Self\u2010rated health was measured using a single\u2010item 5\u2010point Likert scale, and social frailty was assessed using a five\u2010item index. Mediation and moderation analyses were conducted using PROCESS Macro in SPSS, controlling for demographic factors and cognitive function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The number of chronic conditions was positively associated with depressive symptoms (\n                      <jats:italic>B<\/jats:italic>\n                      \u2009=\u20090.245,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Self\u2010rated health partially mediated this relationship (indirect effect:\n                      <jats:italic>B<\/jats:italic>\n                      \u2009=\u20090.092, 95% CI [0.048, 0.142]). Social frailty significantly moderated the association between chronic conditions and depressive symptoms (\n                      <jats:italic>B<\/jats:italic>\n                      \u2009=\u20090.153,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), with the relationship being non\u2010significant at low levels of social frailty but significant at mean and high levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates that chronic conditions affect depressive symptoms both directly and indirectly through self\u2010rated health perceptions. Moreover, social frailty exacerbates the impact of chronic conditions on mental health. These findings highlight the importance of addressing both psychological perceptions and social resources when managing chronic conditions in aging populations, supporting a biopsychosocial approach to healthcare interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/psyg.70079","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T09:51:30Z","timestamp":1754473890000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Chronic Conditions\u2010Depressive Symptoms Association: How Self\u2010Rated Health Mediates and Social Frailty Moderates in Malaysian Ageing Communities"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3198-4212","authenticated-orcid":false,"given":"Hui Foh","family":"Foong","sequence":"first","affiliation":[{"name":"Lee Kuan Yew School of Public Policy, National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahimah","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Malaysian Research Institute on Ageing (MyAgeing\u00ae), Universiti Putra Malaysia  Serdang Selangor Malaysia"},{"name":"Department of Human Development and Family Studies Faculty of Human Ecology, Universiti Putra Malaysia  Serdang Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siti Farra Zillah","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Malaysian Research Institute on Ageing (MyAgeing\u00ae), Universiti Putra Malaysia  Serdang Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad Fazdillah","family":"Bagat","sequence":"additional","affiliation":[{"name":"Malaysian Research Institute on Ageing (MyAgeing\u00ae), Universiti Putra Malaysia  Serdang Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60240-2"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00516-4"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.06.009"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/ijph.2023.1605572"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2012.12.016"},{"issue":"3","key":"e_1_2_11_7_1","first-page":"S538","article-title":"Depressive Symptoms and Onset of Functional Disability Over 2\u2009Years: A Prospective Cohort Study","volume":"67","author":"Kong D.","year":"2019","journal-title":"Journal of the American Geriatrics Society"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.58.110405.085615"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2009.05.013"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2307\/2955359"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2002.50411.x"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10433-017-0414-7"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2015.08.023"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2017.04.015"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-031912-114409"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2010.536141"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2009.05.005"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.847460"},{"key":"e_1_2_11_19_1","first-page":"995","volume-title":"The Biopsychosocial Model of Illness: A Model Whose Time Has Come","author":"Wade D. T.","year":"2017"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.98.2.310"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/jurban\/78.3.458"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000517946"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019579"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-015-0511-4"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017025"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/psyg.13031"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1300\/J018v05n01_09"},{"issue":"2","key":"e_1_2_11_28_1","article-title":"A Single\u2010Item Self\u2010Rated Health Measure Correlates With Objective Health Status in the Elderly: A Survey in Suburban Beijing","volume":"10","author":"Meng Q.","year":"2014","journal-title":"Frontiers in Public Health"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53221.x"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.51.6.1173"},{"key":"e_1_2_11_31_1","volume-title":"Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression\u2010Based Approach","author":"Hayes A. F.","year":"2022"},{"issue":"9","key":"e_1_2_11_32_1","first-page":"1337","article-title":"Validation and Optimal Cut\u2010Off Scores of the Bahasa Malaysia Version of the Montreal Cognitive Assessment (MoCA\u2010BM) for Mild Cognitive Impairment among Community Dwelling Older Adults in Malaysia","volume":"45","author":"Din N. C.","year":"2016","journal-title":"Sains Malaysiana"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.5639"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2020.10.043"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13166"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-023-04444-6"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.31887\/DCNS.2011.13.1\/wkaton"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mad.2020.111383"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.770914"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare13030314"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-014-0185-6"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1465937"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-03033-0"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2021.104555"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/psyg.12696"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.3390\/jal4030016"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41999-024-00931-0"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15225"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2017.03.005"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajag.13409"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11030565"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511665684"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-6494.2009.00600.x"}],"container-title":["Psychogeriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/psyg.70079","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/psyg.70079","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/psyg.70079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T09:29:59Z","timestamp":1773134999000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/psyg.70079"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,6]]},"references-count":52,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/psyg.70079"],"URL":"https:\/\/doi.org\/10.1111\/psyg.70079","archive":["Portico"],"relation":{},"ISSN":["1346-3500","1479-8301"],"issn-type":[{"value":"1346-3500","type":"print"},{"value":"1479-8301","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,6]]},"assertion":[{"value":"2025-04-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70079"}}