{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T05:04:52Z","timestamp":1783919092978,"version":"3.55.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the longitudinal dynamic relationships among frailty, depression, and self-perceptions of aging in community-dwelling older adults, to analyze the mediating role of depression between frailty and aging cognition, and to provide a theoretical basis for physical and mental health interventions for this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A longitudinal follow-up research design was adopted, involving three waves of surveys (T1, T2, T3) conducted with 286 community-dwelling older adults. Assessments were performed using the Frailty Phenotype, a depression scale, and a brief version of the Self-Perceptions of Aging Scale. SPSS 26.0 was used for descriptive statistics and correlation analysis, while Mplus 8.3 was employed to construct cross-lagged panel models. Covariates such as age, gender, education level, the number of chronic diseases, and cognitive function were controlled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cross-lagged panel model demonstrated good fit indices. With the exception of baseline (T1) self-perceptions of aging not significantly predicting the midterm (T2) level, all other core variables exhibited significant temporal stability. Controlling for autoregressive effects and covariates, significant bidirectional predictive relationships emerged: T1 frailty significantly predicted T2 depression, and T2 depression significantly predicted T3 frailty; T1 depression significantly predicted T2 self-perceptions of aging, and T2 self-perceptions of aging significantly predicted T3 depression. Furthermore, the direct predictive path from frailty to self-perceptions of aging was not significant, suggesting that depression may constitute an indirect pathway linking frailty and self-perceptions of aging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study supports a dynamic psychosomatic interaction pattern among frailty, depression, and self-perceptions of aging in community-dwelling older adults. Depression serves as a core hub connecting physiological frailty and subjective aging cognition. The findings support the Psychosomatic Interaction Theory (PIT) and Stereotype Embodiment Theory (SET). These results suggest that community nursing practice should emphasize early screening and intervention for depressive symptoms. Targeting this potentially important depressive pathway may help interrupt the adverse cycle of \u201cphysiological frailty \u2013 psychological depression - negative aging cognition\u201d among older adults can be disrupted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1880962","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T04:23:35Z","timestamp":1783916615000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal associations and mechanisms linking frailty, depression, and self-perceptions of aging among community-dwelling older adults: a psychosomatic interaction perspective"],"prefix":"10.3389","volume":"14","author":[{"given":"Yongwei","family":"Liu","sequence":"first","affiliation":[{"name":"School of Nursing, Henan Medical University","place":["Xinxiang, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyang","family":"Luo","sequence":"additional","affiliation":[{"name":"School of Nursing, Henan Medical University","place":["Xinxiang, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjun","family":"Sun","sequence":"additional","affiliation":[{"name":"School of Nursing, Henan Medical University","place":["Xinxiang, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huimin","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Nursing, Henan Medical University","place":["Xinxiang, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Luo","sequence":"additional","affiliation":[{"name":"School of Nursing, Henan Medical University","place":["Xinxiang, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guodong","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing, Henan Medical University","place":["Xinxiang, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guiying","family":"Yao","sequence":"additional","affiliation":[{"name":"School of Nursing, Henan Medical University","place":["Xinxiang, Henan, China"]},{"name":"Xinxiang Key Laboratory for Chronic Disease Basic Research and Intelligent Care","place":["Xinxiang, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1093\/gerona\/glx098","article-title":"Prevalence and correlates of frailty among community-dwelling Chinese older adults: the China health and retirement longitudinal study","volume":"73","author":"Wu","year":"2017","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1967","DOI":"10.1016\/S0140-6736(22)01546-X","article-title":"The path to healthy ageing in China: a Peking University-lancet commission","volume":"400","author":"Chen","year":"2022","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1111\/j.1532-5415.2006.00745.x","article-title":"Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society\/National Institute on Aging research conference on frailty in older adults","volume":"54","author":"Walston","year":"2006","journal-title":"J Am Geriatr Soc"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1186\/s12877-020-01530-x","article-title":"Changes in frailty among community-dwelling Chinese older adults and its predictors: evidence from a two-year longitudinal study","volume":"20","author":"Ye","year":"2020","journal-title":"BMC Geriatr"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1163.e1","DOI":"10.1016\/j.jamda.2016.09.010","article-title":"Frailty and the prediction of negative health outcomes: a meta-analysis","volume":"17","author":"Vermeiren","year":"2016","journal-title":"J Am Med Dir Assoc"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"252","DOI":"10.5582\/bst.2023.01204","article-title":"Healthy aging, early screening, and interventions for frailty in the elderly","volume":"17","author":"Deng","year":"2023","journal-title":"Biosci Trends"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1111\/ajag.12502","article-title":"Feasibility and validity of frailty measurement in geriatric rehabilitation","volume":"37","author":"Arjunan","year":"2018","journal-title":"Australas J 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East China Norm. Univ. Educ. Sci."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"593","DOI":"10.3390\/healthcare9050593","article-title":"The reciprocal relationship between frailty and depressive symptoms among older adults in rural China: a cross-lag analysis","volume":"9","author":"Wang","year":"2021","journal-title":"Healthcare (Basel)"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.neurobiolaging.2022.10.006","article-title":"Depressive symptoms are associated with reduced positivity preferences in episodic memory in aging","volume":"121","author":"James","year":"2023","journal-title":"Neurobiol Aging"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1007\/s10597-021-00842-5","article-title":"The important role of stereotypes in the relation between mental health literacy and stigmatization of depression and psychosis in the community","volume":"58","author":"Doll","year":"2022","journal-title":"Community Ment Health J"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1649231","DOI":"10.3389\/fpsyg.2025.1649231","article-title":"Longitudinal associations between psychological well-being and depressive symptoms among older adults in the Baltic states","volume":"16","author":"Kairys","year":"2025","journal-title":"Front Psychol"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1531101","DOI":"10.3389\/fpubh.2025.1531101","article-title":"Coexisting frailty and depression associated with low physical activity and quality of life in Saudi community-dwelling older adults: a cross-sectional study","volume":"13","author":"Alhwoaimel","year":"2025","journal-title":"Front Public Health"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"4411","DOI":"10.1038\/s41467-024-48827-8","article-title":"The brain structure, inflammatory, and genetic mechanisms mediate the association between physical frailty and depression","volume":"15","author":"Jiang","year":"2024","journal-title":"Nat Commun"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1159\/000543830","article-title":"The mediating effect of depressive symptoms between frailty and cognitive impairment in the northeast Chinese older adults","volume":"54","author":"Geng","year":"2025","journal-title":"Dement Geriatr Cogn Disord"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1483","DOI":"10.1017\/S0144686X1500046X","article-title":"\u2018Thinking you\u2019re old and frail\u2019: a qualitative study of frailty in older adults","volume":"36","author":"Warmoth","year":"2016","journal-title":"Ageing Soc"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1571977","DOI":"10.3389\/fpubh.2025.1571977","article-title":"The mediating effect of self-perceived aging on social capital and depression among Chinese community-dwelling older adult: a cross-sectional study","volume":"13","author":"Ye","year":"2025","journal-title":"Front Public Health"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1176\/appi.ajp.2015.15020152","article-title":"Inflammation: depression fans the flames and feasts on the heat","volume":"172","author":"Kiecolt-Glaser","year":"2015","journal-title":"Am J Psychiatry"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"1947","DOI":"10.2147\/CIA.S69632","article-title":"Depression and frailty in later life: a systematic review","volume":"10","author":"Vaughan","year":"2015","journal-title":"Clin Interv Aging"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"S365","DOI":"10.4103\/jpbs.jpbs_592_23","article-title":"Efficacy of cognitive behaviour therapy in major depressive disorders: an original research","volume":"16","author":"Das","year":"2024","journal-title":"J Pharm Bioallied Sci"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1880962\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T04:23:36Z","timestamp":1783916616000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1880962\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":48,"alternative-id":["10.3389\/fpubh.2026.1880962"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1880962","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]},"article-number":"1880962"}}