Health Consequences of COVID-19 Pandemic in Older Adults with Musculoskeletal Conditions: A Cross-Sectional Path Analysis Model

<b>Background/Objective</b>: The sequelae of COVID-19 on geriatric health is profound, yet its consequences on mental well-being remain insufficiently elucidated, particularly in older adults with musculoskeletal conditions. This study aimed to explore the interrelationships and magnitude of the effects of fear of COVID-19, fear of falls, physical activity, and social frailty on depressive symptoms in this population. <b>Methods</b>: Purposive sampling was applied to recruit 292 older adults with musculoskeletal conditions. Data were collected through structured interviews (face-to-face and telephone) using standard questionnaires. Path analysis with Satorra-Bentler correction examined the relationships in the proposed model of depressive symptoms. The model fit indices were evaluated using the chi-square (χ²); the goodness-of-fit test was assessed with standard criteria of the comparative fit index (CFI ≥ 0.95), the Tucker-Lewis index (TLI ≥ 0.95), the root mean squared error of approximation (RMSEA < 0.08), and the standardized root mean square residual (SRMR < 0.05). <b>Results</b>: Mean participant age was 70.30 ± 6.56 years, with 74.3% female. The path analysis model demonstrated an excellent fit indicating χ² = 0.007 (<i>p</i> = 0.933), CFI and TLI = 1.000, RMSEA = 0.000, SRMR = 0.001. Fear of COVID-19 negatively indirectly impacted depressive symptoms (β = -0.07, <i>p</i> = 0.017), while physical activity had a positive direct effect (β = 0.16, <i>p</i> = 0.004). Fear of COVID-19 directly influenced social frailty (β = 0.18, <i>p</i> = 0.003) but had a negative direct impact on physical activity (β = -0.37, <i>p</i> = 0.000). However, fear of falling did not show a significant relationship with the other study variables. <b>Conclusions</b>: Depressive symptoms entail physical and psychosocial consequences. Physical activity has a positive effect on depressive symptoms. Fear of COVID-19 increases social frailty, while increasing physical activity reduces this fear. Future research should evaluate longitudinal effects and investigate evidence-based public health interventions or tailored cognitive-behavioral interventions to reduce pandemic-related fear and prevent mental health sequelae.