STUDY PROTOCOL article
Front. Med.
Sec. Geriatric Medicine
Frailty and Lived Experiences in Older Adults with Osteoporosis: Protocol for a Convergent Mixed-Methods Study
Provisionally accepted
- 1Health Science Center, Yangtze University, Jingzhou, China
- 2Peking University Shenzhen Hospital, Shenzhen, China
- 3Anhui Medical University School of Nursing, Hefei, China
- 4Shantou University Medical College, Shantou, China
- 5School of Nursing and Health, Henan University, Kaifeng, China
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Background:older adults is characterised by an age‑related decline in bone mineral density (BMD). Frailty-a distinct age‑associated geriatric syndrome-further exacerbates this condition. The concomitance of osteoporosis and frailty in older adults markedly heightens the risk of functional decline, with attendant profound psychosocial sequelae. A mixed‑methods study design is essential to achieve a comprehensive, patient‑centred understanding of this phenomenon. Methods:This study will adopt a convergent mixed-methods design comprising three primary phases: (1) Quantitative phase: A cross-sectional survey will be conducted among older adults diagnosed with osteoporosis. Data collection will include demographic variables, scores from the Edmonton Frail Scale, Activities of Daily Living (ADL) assessments, Nutritional Risk Screening (NRS) assessments, and the Hospital Anxiety and Depression Scale (HADS). In addition, handgrip strength will be measured, alongside relevant laboratory parameters. Data will undergo descriptive analysis, followed by univariate analyses and multivariate binary logistic regression to identify factors associated with frailty. (2) Qualitative phase: Semi-structured, face-to-face interviews will be performed with participants classified as frail according to their frailty assessment scores, enabling an in-depth exploration of their subjective perceptions and experiences of frailty within the context of osteoporosis. (3) Integration phase: Key findings from both quantitative and qualitative components will be analysed and synthesised to generate a comprehensive understanding of the phenomenon. Discussion:This study aims to explore the prevalence and clinical characteristics of frailty among older adults with osteoporosis. It also seeks to identify associated risk factors and to explore patients' subjective experiences of living with frailty in the context of osteoporosis. Clinical trial registration:This trial has been registered with the Chinese Clinical Trial Registry (ChiCTR2500097059).
Keywords: older adults, Osteoporosis, Frailty, Mixed-methods study, protocol
Received: 11 Aug 2025; Accepted: 26 Nov 2025.
Copyright: © 2025 Wang, Gao, Liu, Tan, Li, Lin and Lan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Pei Liu
Zhen Tan
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