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Background <p>The global population of older adults with hypertension is increasing, and cognitive decline is recognized as a potential risk factor impacting their quality of life. However, current evidence remains limited regarding the associations among cognitive function, frailty, medication discrepancies, and quality of life in older adults. This study examines the association between cognitive function and quality of life in older adults with hypertension and evaluates the potential mediating roles of frailty and medication deviation.</p> Methods <p>A cross-sectional study using multi-stage stratified random sampling surveyed residents in a province of eastern China. Older adults aged 60 and above with hypertension who met the inclusion and exclusion criteria were selected for analysis. The questionnaire includes assessments of quality of life, cognitive function (AD8), frailty (FRAIL), and medication discrepancies (MMDT). Parallel mediation analysis was performed with the PROCESS macro in SPSS software.</p> Results <p>In total, 1,065 older hypertension patients met the inclusion criteria. Participants had an average age of 70.65 years (SD = 6.18), with the majority being female (65.0%). Cognitive function, frailty, and medication discrepancies showed significant positive correlations (<i>P</i> &lt; 0.001), whereas quality of life was significantly negatively correlated with each of these variables (<i>P</i> &lt; 0.001). The total effect of cognitive function on quality of life was − 0.895 (<i>P</i> &lt; 0.001), and the direct effect was − 0.668 (<i>P</i> &lt; 0.001). The combined indirect effect of frailty and medication discrepancies was − 0.227 (95% <i>CI</i>: -0.303, -0.157), suggesting that these factors partially mediate the relationship between cognitive function and quality of life.</p> Conclusion <p>The study results might suggest that cognitive function can indirectly affect quality of life through frailty and medication discrepancies. Therefore, interventions designed to reduce frailty and improve medication adherence are recommended to enhance the quality of life for older hypertension patients.</p> Clinical trial number <p>Not applicable.</p>

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The relationship between cognitive function and quality of life in older hypertension patients: a parallel mediation effect of frailty and medication discrepancies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月17日

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  • Lifang Zhou,
  • Zhongming Chen,
  • Xiaona Li,
  • Yixuan Wu,
  • Hui Guan,
  • Wenqiang Yin,
  • Kui Sun,
  • Qianqian Yu

摘要

Background

The global population of older adults with hypertension is increasing, and cognitive decline is recognized as a potential risk factor impacting their quality of life. However, current evidence remains limited regarding the associations among cognitive function, frailty, medication discrepancies, and quality of life in older adults. This study examines the association between cognitive function and quality of life in older adults with hypertension and evaluates the potential mediating roles of frailty and medication deviation.

Methods

A cross-sectional study using multi-stage stratified random sampling surveyed residents in a province of eastern China. Older adults aged 60 and above with hypertension who met the inclusion and exclusion criteria were selected for analysis. The questionnaire includes assessments of quality of life, cognitive function (AD8), frailty (FRAIL), and medication discrepancies (MMDT). Parallel mediation analysis was performed with the PROCESS macro in SPSS software.

Results

In total, 1,065 older hypertension patients met the inclusion criteria. Participants had an average age of 70.65 years (SD = 6.18), with the majority being female (65.0%). Cognitive function, frailty, and medication discrepancies showed significant positive correlations (P < 0.001), whereas quality of life was significantly negatively correlated with each of these variables (P < 0.001). The total effect of cognitive function on quality of life was − 0.895 (P < 0.001), and the direct effect was − 0.668 (P < 0.001). The combined indirect effect of frailty and medication discrepancies was − 0.227 (95% CI: -0.303, -0.157), suggesting that these factors partially mediate the relationship between cognitive function and quality of life.

Conclusion

The study results might suggest that cognitive function can indirectly affect quality of life through frailty and medication discrepancies. Therefore, interventions designed to reduce frailty and improve medication adherence are recommended to enhance the quality of life for older hypertension patients.

Clinical trial number

Not applicable.