Article Data

  • Views 197
  • Dowloads 142

Original Research

Open Access

Prediction of Physical Characteristics, Cognitive Function and Community Participation on Mental Health State of Frail Male Elderly Outpatients

  • Hsiang-Chun Lin1,2,
  • Shu-Fang Chang3,*,
  • Po-Han Wu4
  • Ching-Yun Kao5,*,

1National University of Tainan Department of Information and Learning Technology, National University of Tainan, 700 Tainan, Taiwan

2Mi Bao Postpartum Nursing Care Center, Head Nurse of Nursing Care Center, Care Center of Postpartum Nursing, 730 Tainan, Taiwan

3School of Nursing, College of Nursing, National Taipei, University of Nursing and Health Sciences, 112 Taipei, Taiwan

4National University of Tainan Department of Information and Learning Technology, 700 Tainan, Taiwan

5Department of Family Medicine, Saint Paul’s Hospital, Taoyuan District, 330 Taoyuan, Taiwan

DOI: 10.31083/j.jomh1809185 Vol.18,Issue 9,September 2022 pp.1-14

Published: 22 September 2022

*Corresponding Author(s): Shu-Fang Chang E-mail:
*Corresponding Author(s): Ching-Yun Kao E-mail:


Background: It has been pointed out that the elderly with frailty are more likely to be at risk of depression than the elderly without frailty. There are few researches that explored the predictability of physical characteristics, cognitive function, and community participation on the mental health state of male elderly outpatients with frailty. The purpose of this study was to explore the predictability of the basic attributes, physical characteristics, cognitive function, and community participation on the mental health state of male elderly outpatients with frailty. Methods: Through purposive sampling, the questionnaires were distributed and collected in the internal medicine clinic of a teaching hospital in northern Taiwan to include a total of 190 male elders as the cases of this study. The data collection included basic attributes, physical characteristics, cognitive function, community participation, and mental health state evaluation. Results: The results of the study show that scores of the male elderly with frailty were statistically different in mental health state in terms of age (t = –3.54, p < 0.001), domicile (t = 15.99, p < 0.001), income (t = 7.81, p < 0.005), self-perceived health status (t = 35.39, p < 0.001), drinking (t = 7.03, p < 0.05); left hand muscle strength (t = 2.15, p < 0.05), average muscle strength of both hands (t = 2.03, p < 0.05); in terms of physical characteristics between the instrumental activities of daily living total score (t = 5.03, p < 0.001) and instrumental activities of daily living scale grouping (t = 14.82, p < 0.001), and cognitive function score (t = 2.87, p < 0.005), as well as for community participation in Control (t = 2.57, p < 0.05), wholehearted devotion (t = 2.13, p < 0.05) and Community participation grouping (t = 5.66, p < 0.05). In addition, self-perceived good and normal health status (OR = 0.09, p = 0.004; OR = 0.12, p = 0.026), mild disability (OR = 4.74, p = 0.021), and mild dementia (OR = 0.18, p = 0.044) can all predict the mental health state of the elderly. Conclusions: Self-perceived health status, mild disability, and mild dementia could predict the mental health state of the male elderly with frailty and is worthy of attention.


frailty; male; physical characteristics; cognitive function; community participation; mental health state

Cite and Share

Hsiang-Chun Lin,Shu-Fang Chang,Po-Han Wu,Ching-Yun Kao. Prediction of Physical Characteristics, Cognitive Function and Community Participation on Mental Health State of Frail Male Elderly Outpatients. Journal of Men's Health. 2022. 18(9);1-14.


[1] World Health Organization. Active Ageing: A Policy Frame-work. 2002. Available at: (Accessed: 27 April 2022).

[2] Chang S, Lin P. Frail phenotype and mortality prediction: a sys-tematic review and meta-analysis of prospective cohort studies. International Journal of Nursing Studies. 2015; 52: 1362–1374.

[3] Dent E, Kowal P, Hoogendijk EO. Frailty measurement in re-search and clinical practice: a review. European Journal of In-ternal Medicine. 2016; 31: 3–10.

[4] .Mello ADC, Engstrom EM, Alves LC. Health-related and socio-demographic factors associated with frailty in the elderly: a systematic literature review. Cadernos De SaúDe PúBlica. 2014; 30: 1143–1168.

[5] Pan WS, Chen MY. Using Evidence-Based Nursing to Im-prove Lower Limb Muscle Strength and Delay Disability in Community-Dwelling Older Adults with Frailty. VGH Nursing. 2021; 38: 63–70

[6] Lin HC, Chang SF, Chen YH. The relations among physical in-dicators, cognitive status, community participation, and depres-sion of the frail male elderly in Taiwan. American Journal of Men’s Health. 2020; 14: 1–13.

[7] Wei CS. Research on the moderating effect of social participa-tion on health status and depression in the elderly [Master’s the-sis]. Department of Long-Term Care, National Taipei University of Nursing and Health Sciences Institutional Repository. 2021.

[8] Chu W, Chang S, Ho H, Lin H. The Relationship between De-pression and Frailty in Community‐Dwelling Older People: a Systematic Review and Meta‐Analysis of 84,351 Older Adults. Journal of Nursing Scholarship. 2019; 51: 547–559.

[9] Lakey SL, LaCroix AZ, Gray SL, Borson S, Williams CD, Cal-houn D, et al. Antidepressant Use, Depressive Symptoms, and Incident Frailty in Women Aged 65 and Older from the Women’s Health Initiative Observational Study. Journal of the American Geriatrics Society. 2012; 60: 854–861.

[10] Ku PW, Chen ST, Sun WJ, Chen LJ. Review of Sedentary Be-haviors and Depressive Symptoms in Older Adult. Chinese Jour-nal of Psychology. 2020; 62: 151–170.

[11] Ensrud KE, Ewing SK, Taylor BC, Fink HA, Stone KL, Cauley JA, et al. Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures. The Journals of Gerontology, Series A: Biological Sciences. 2008; 62: 744–751.

[12] Luciani A, Ascione G, Bertuzzi C, Marussi D, Codecà C, Di Maria G, et al. Detecting Disabilities in Older Patients with Can-cer: Comparison between Comprehensive Geriatric Assessment and Vulnerable Elders Survey-13. Journal of Clinical Oncology. 2010; 28: 2046–2050.

[13] Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): re-cent evidence and development of a shorter version. Clinical Gerontologist: The Journal of Aging and Mental Health. 1986.

[14] Huang SY, Sung HC. Depression: A Concept Analysis. VGH Nursing. 2016; 33: 204–211.

[15] Lawton MP, Brody EM. Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living. The Gerontologist. 1969; 9: 179–186.

[16] Chang HY, Lee SD, Chen BJ, Hsieh, CL. Assessment of instru-mental activities of daily living needs among residents in long-term care facilities. Taiwan Geriatrics and Gerontology. 2006; 2: 116–129.

[17] Mathiowetz VG, Finlayson ML, Matuska KM, Chen HY, Luo P. Randomized controlled trial of an energy conservation course for persons with multiple sclerosis. Multiple Sclerosis Journal. 2005; 11: 592–601.

[18] Yang YA. The Effect of a Group Exercise Program and Physi-cal Performance Cutoff value for Unstable and Frail Older adults [Master’s thesis]. School of Physical Therapy, Chung Shan Med-ical University. 2019.

[19] Chang S, Yang R, Lin T, Chiu S, Chen M, Lee H. The Dis-crimination of Using the Short Physical Performance Battery to Screen Frailty for Community-Dwelling Elderly People. Journal of Nursing Scholarship. 2014; 46: 207–215.

[20] Rikli RE, Jones CJ. Functional Fitness Normative Scores for Community-Residing Older Adults, Ages 60-94. Journal of Ag-ing and Physical Activity. 1999; 7: 162–181.

[21] Bohannon RW, Schaubert KL. Test–Retest Reliability of Grip-strength Measures Obtained over a 12-week Interval from Community-dwelling Elders. Journal of Hand Therapy. 2005; 18: 426–428.

[22] James T, Rikli R, Jones C. The reliability and validity of a 30 second arm curl as a measure of upper body strength in older adults. Southwest American College of Sports Medicine Con-ference. 1998; 27: 113–120.

[23] Chang T, Chueh K. Relationship between Elderly Depression and Health Status in Male Veterans. Journal of Nursing Re-search. 2011; 19: 298–304.

[24] Wu KL. A Study on the Community Participation Motivation, Participation Level and Life Adaptation of the Elderly [Master’s thesis]. Graduate Institute of Adult Education, NKNU. 1999.

[25] Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. Journal of Psychiatric Research. 1975; 12: 189–198.

[26] Guo NW, Liu HC, Wong PF, Liao KK, Yan SH, Lin KP, et al. Chinese version and norms of the Mini-Mental State Examina-tion. Journal of Rehabilitation Medicine Association. 1988; 16: e59.

[27] Yao G, Chien CC. V Development and validation of the WHOQOL-OLD in Taiwan. Taiwan Journal of Public Health. 2017; 36: 239–258.

[28] Lin WT, Yen CH, Lee MC. Comprehensive Geriatric Assess-ment: A Case of Major Depressive Disorder, Impaired Cog-nitive Function and Subclinical Hyperthyroidism. Journal of Medicine and Health. 2018; 7: 53–63.

[29] Tur-Sinai A, Halperin D, Ben David N, Lowenstein A, Katz R. Cessation of Care for Frail Older Adults: Physical, Psycholog-ical and Economic Outcomes for Family Carers. International Journal of Environmental Research and Public Health. 2022; 19: 3570.

[30] Kojima G. Increased healthcare costs associated with frailty among community-dwelling older people: a systematic review and meta-analysis. Archives of Gerontology and Geriatrics. 2019; 84: 103898.

[31] Palomo-Vélez G, García F, Arauna D, Muñoz-Mendoza CL, Fuentes E, Palomo I. Effects of frailty status on happiness and life satisfaction: the mediating role of self-perceived health. Re-vista Latinoamericana De Psicología. 2020; 52: 95–103.

[32] Collard RM, Comijs HC, Naarding P, Penninx BW, Milaneschi Y, Ferrucci L, et al. Frailty as a Predictor of the Incidence and Course of Depressed Mood. Journal of the American Medical Directors Association. 2015; 16: 509–514.

[33] Chen L, Stevinson C, Ku P, Chang Y, Chu D. Relationships of leisure-time and non-leisure-time physical activity with depres-sive symptoms: a population-based study of Taiwanese older adults. International Journal of Behavioral Nutrition and Physi-cal Activity. 2012; 9: 28.

[34] Lu BL, Chang SL, Chen CY, Wu CH, Chang CI, Chen CY. Frailty Status and Associated Factors in Outpatient Older People with Chronic Disease. Taiwan Geriatr Gerontol. 2010; 5: 36–49.

[35] Ocampo-Chaparro JM, Reyes-Ortiz CA, Castro-Flórez X, Gómez F. Frailty in older adults and their association with social determinants of Health. The SABE Colombia Study. Colombia Médica. 2019; 50: 89–101.

[36] Lu HC, Chiu ST, Chang CM. An Exploration of Exercise In-tervention and Elder Depression. NCYU Physical Education, Health & Recreation Journal. 2015; 14: 153–162.

[37] Wang CC, Chang HJ. The Relationship of Religiosity toward Life Satisfaction and Depression among Elderly People in Tai-wan. The Journal of Long-Term Care. 2018; 22: 147–169.

[38] Serra-Prat M, Lorenzo I, Palomera E, Ramírez S, Yébenes JC. Total Body Water and Intracellular Water Relationships with Muscle Strength, Frailty and Functional Performance in an El-derly Population. a Cross-Sectional Study. The Journal of Nu-trition, Health & Aging. 2019; 23: 96–101.

[39] Tang TC, Hwang AC, Peng LN.Compare and Contrast Sarcope-nia Diagnostic Criteria. Taiwan Association of Gerontology and Geriatrics. 2016; 11: 213–224.

[40] Lin YH, Yen CH, Kuo MS, Hu MH, Wang CY. The Cutoff Values of Performance Tests to Separate Community-Dwelling Older Adults with and without Physical Disability. Taiwan Geri-atr Gerontol. 2012; 7: 160–174.

[41] Hou MT, Wu PY, Lin YB, Chang YF, Chen CY, Guan D S, et al. Physical Fitness Performance and Normative Score of Elderly Male Rural Dwellers. Taiwan Association of Gerontology and Geriatrics. 2011; 6: 190–202.

[42] Sports Administration Ministry of Education. Senior Physi-cal Fitness. 2019. Available at: (Accessed: 27 April 2022).

[43] Chou MH, Chen FJ, Chiu CF, Lin YT. Factors Influencing Frailty in Elderly Hospitalized Patients. VGH Nursing. 2019; 36: 27–38.

[44] Chen ZF, Chao YH, Tang JY, Jhang YJ, Yi YF, Li SR, et al. Investigation the impact of community elderly depression and activation of aging study. Journal of Health and Architect. 2015; 2: 56–64.

[45] Fang L, Fang SH, Fang CL. Effects of exercise on depression in older people: a systematic review and meta-analysis. Taiwan Journal of Public Health. 2020; 39: 278–291.

[46] Lindqvist D, Kaufman E, Brundin L, Hall S, Surova Y, Hansson O. Non-motor symptoms in patients with Parkinson’s disease–correlations with inflammatory cytokines in serum. PLoS ONE. 2012; 7: e47387.

[47] Fried EI, Haslbeck J. Using network analysis to examine links between individual depression symptoms, inflammatory mark-ers, and covariates. PsyArXiv. 2019. (in press)

[48] Chiu C, Du Y. Longitudinal investigation of the reciprocal re-lationship between depressive symptoms and glycemic control: the moderation effects of sex and perceived support. Journal of Diabetes Investigation. 2019; 10: 801–808.

[49] Tseng WT. The Mediating Effect of Social Participation Be-tween Physiological Health Status and Depressive Symptoms among Community-Dwelling Elders [Master’s thesis]. Institute of Clinical and Community Health Nursing, National Yang-Ming University. 2015.

[50] Marinus, Nastasia, et al. Frailty Test Battery Development in-cluding Physical, Socio-Psychological and Cognitive Domains for Cardiovascular Disease Patients: A Preliminary Study. Jour-nal of Clinical Medicine. 2022; 11: 1926.

[51] Ho HT, Liu LF, Guo NW. Factors of Geriatric Depression in Southern Taiwan. Taiwan Journal of Family Medicine. 2016; 26: 100–108.

[52] Lin WJ. The association among depression, Daily Living Ac-tivity and Cognitive function in Taichung county’ resident over 50 years old [Master’s thesis]. School of Nursing, Hungkuang University. 2010.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Directory of Open Access Journals (DOAJ) DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.

SCImago The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus® database (Elsevier B.V.)

Publication Forum - JUFO (Federation of Finnish Learned Societies) Publication Forum is a classification of publication channels created by the Finnish scientific community to support the quality assessment of academic research.

Scopus CiteScore 0.7 (2021) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Norwegian Register for Scientific Journals, Series and Publishers Search for publication channels (journals, series and publishers) in the Norwegian Register for Scientific Journals, Series and Publishers to see if they are considered as scientific. (

Submission Turnaround Time