Physical resilience as a moderator of the relationship between frailty and disability in older adults with osteoarthritis

Aims Frailty is a leading cause of deteriorating physical function of older adults with osteoarthritis. This study examined a model of frailty with the goals of (1) exploring the direct effect of osteoarthritic symptoms on disability and the mediating effect of frailty on disability and (2) determining whether both effects are moderated by physical resilience. Design A cross-sectional descriptive study. Methods Data collection was conducted among patients 65-92 years of age (N = 235) who visited primary medical centres for the management of chronic arthritic pain between July and December 2019. Participants completed a questionnaire measuring osteoarthritic symptoms, frailty, physical resilience, and disability. SPSS 25.0 was used to analyse the conditional process model. This study was reported following the STROBE guidelines. Results Frailty was shown to be a mediator between osteoarthritic symptoms and disability. Furthermore, physical resilience played a role as a moderator in both the direct and indirect pathways of this mediating relationship. Conclusion The findings emphasize the detrimental effects of osteoarthritic symptoms on disability through frailty, and the moderated mediation results suggest that these effects were conditional on physical resilience, which is a modifiable internal resource of individuals. When planning nursing interventions for older adults with osteoarthritis, nurses need to consider physical resilience as a moderator to prevent frailty and disability.

Automated summary

Frailty is a leading cause of deteriorating physical function in older adults with osteoarthritis. This study found that frailty mediates the relationship between osteoarthritic symptoms and disability, and physical resilience moderates both the direct and indirect pathways of this mediating relationship. These findings emphasize the detrimental effects of osteoarthritic symptoms on disability through frailty, and suggest that these effects are conditional on an individual's physical resilience.