Frailty, resilience, instrumental activities of daily living, and cognitive function in older adults with type 2 diabetes: A parallel mediation analysis

Background Previous studies have identified physical frailty as a key factor associated with cognitive function. However, the potential roles of psychological resilience and instrumental activities of daily living (IADL) in this association remain underexplored. Objective To examine the associations among frailty, psychological resilience, IADL, and cognitive function in older adults with type 2 diabetes. Methods This cross-sectional study included 313 older adults with type 2 diabetes. Cognitive function, frailty, psychological resilience, and IADL were assessed using validated instruments. Associations were examined within a mediation analysis framework using the PROCESS macro v4.0 (Model 4), adjusting for age, gender, years of education, and glycated hemoglobin (HbA1c). Results The results indicated that frailty was negatively correlated with cognitive function. Both psychological resilience and IADL demonstrated significant indirect associations in the relationship between frailty and cognitive function. Conclusions These findings highlight interrelationships among frailty, functional capacity, and psychological factors and provide a basis for future longitudinal research on cognitive health in older adults with type 2 diabetes.