Depression and social frailty in elderly patients receiving maintenance hemodialysis: multiple mediating roles of bidirectional social support and personal mastery

Social frailty among elderly MHD patients is at a moderate level, with 27.02% experiencing moderate to severe social frailty. The prevalence of depressive symptoms was 53.6%. Depression significantly predicts social frailty, while bidirectional social support and personal mastery serve as partial mediators. Enhancing these psychosocial factors may help reduce the risk or severity of social frailty in this population.