Depression mediates the relationship between illness perception and frailty in hospitalized patients with heart failure

Frailty is prevalent and closely related to the prognosis of patients with heart failure (HF). Illness perception, depression, and anxiety may be the potential modifiable factors for frailty. Nevertheless, there is a lack of understanding regarding the relationships among these variables in patients with HF. To explore the effect of illness perception on frailty and examine the mediating effects of depression and anxiety between illness perception and frailty in patients with HF. Between February and May 2023, 164 participants from a university-affiliated hospital in China were surveyed with the Tilburg Frailty Indicator, the Brief Illness Perception Questionnaire, the Patient Health Questionnaire, and the Generalized Anxiety Disorder Questionnaire. The mediation model was tested using Model 4 of PROCESS macro for SPSS. Illness perception had a significant positive total effect on frailty ( β =0.616). In addition, depression served as a partial mediator in the relationship between illness perception and frailty ( β =0.305), and the indirect effect accounted for 49.51 % of the total effect. However, the mediating effect of anxiety on the relationship between illness perception and frailty could not be established. Illness perception and depression are significant predictors of frailty among patients with HF. Depression mediates the relationship between illness perception and frailty. Interventions that focus on improving both illness perception and depression may help reduce frailty in this population.