Association of oral frailty, social support, and technophobia with depressive symptoms in Chinese older adults with chronic diseases: a cross-sectional study

This study aimed to examine the associations of oral frailty, social support, and technophobia with depressive symptoms in Chinese older adults with chronic diseases. A hospital-based cross-sectional study was conducted from February to April 2025 in selected departments of a tertiary hospital in Anhui Province, China. Participants were adults aged 60 years or older with at least one physician-diagnosed chronic disease. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), with a score of ≥ 10 indicating depressive symptoms. Oral frailty, social support, and technophobia were measured using the Oral Frailty Index-8 (OFI-8), Oslo Social Support Scale-3 (OSSS-3), and Technophobia Scale, respectively. Pearson correlation analysis was used to examine correlations between PHQ-9 total scores and the main study variables. Multivariable binary logistic regression was performed to examine factors associated with depressive symptoms, adjusting for demographic, social, health-related variables, and the number of chronic diseases. A total of 525 participants were included, and 108 participants (20.6%) had depressive symptoms. PHQ-9 total scores were positively correlated with OFI-8 total scores (r = 0.616) and technophobia total scores (r = 0.635), and negatively correlated with OSSS-3 total scores (r = - 0.576). In the fully adjusted logistic regression model, oral frailty was associated with higher odds of depressive symptoms (adjusted OR = 7.148, 95% CI: 2.740-18.653), higher social support was associated with lower odds of depressive symptoms (adjusted OR = 0.264, 95% CI: 0.177-0.396), and higher technophobia was associated with higher odds of depressive symptoms (adjusted OR = 1.246, 95% CI: 1.158-1.340). In the technophobia subdomain model, techno-anxiety and privacy concerns were significantly associated with depressive symptoms, whereas techno-paranoia was not independently associated with depressive symptoms. Oral frailty, social support, and technophobia remained associated with depressive symptoms among Chinese older adults with chronic diseases after adjustment for potential confounders. These findings suggest that oral functional status, perceived social support, and technology-related concerns may be considered in multidimensional assessment of depressive symptoms in this population. Longitudinal and intervention studies are needed to clarify causal relationships and intervention effects.