The influence of dyspnea on social frailty in elderly patients with chronic obstructive pulmonary disease: The mediating effects of social support and depression symptoms.

BACKGROUND

Dyspnea in elderly COPD patients may contribute to social frailty by limiting social engagement and increasing emotional distress, therefore clarifying the underlying mechanisms is crucial for developing effective interventions.

OBJECTIVES

To investigate the prevalence of social frailty in elderly COPD patients and assess the mediating effects of social support and depressive symptoms on the relationship between dyspnea and social frailty.

METHODS

Between November 2024 and May 2025, 245 older patients with COPD in Taiyuan City participated in this study. A self-reported questionnaire was used to evaluate dyspnea, social support, depressive symptoms, and social frailty. Structural equation modeling was employed for data analysis.

RESULTS

Dyspnea in elder patients with COPD were directly related to social frailty. Social support and depressive symptoms jointly mediate the relationship between dyspnea and social frailty, accounting for a total indirect effect of 0.211 and a total effect of 0.580, resulting in a mediation effect of 36.42%.

CONCLUSIONS

The study reveals that social support and depressive symptoms serve as multiple mediators in the relationship between dyspnea and social frailty. Dyspnea can exacerbate social frailty in COPD patients via the effect of social support and depressive symptoms.