Self-Care, Treatment Adherence, and Frailty in Older Adults With Hypertension: A Descriptive Correlational Study

BACKGROUND: Hypertension is a prevalent condition among older adults and a major contributor to morbidity, mortality, and frailty in this population. Self-care and treatment adherence are critical for disease control; however, their interplay with frailty in older hypertensive populations remains underexplored. OBJECTIVE: In this study, we aimed to evaluate self-care, treatment adherence, and frailty in older adults with hypertension and to examine the interrelationships among these variables. METHODS: A descriptive correlational study was conducted with 224 older adults with hypertension aged ≥65 years who attended a geriatrics outpatient clinic. Self-care, adherence, and frailty were assessed using the Hypertension Self-Care, Hill-Bone Hypertension Treatment Adherence, and Edmonton Frailty scales, respectively. Data were analyzed using descriptive statistics, correlation, multiple logistic regression, and structural equation modeling. RESULTS: Only 8% of participants demonstrated adequate self-care, and all participants were classified as having low adherence to antihypertensive treatment according to the scale criteria. Frailty was prevalent, with 6.7% of patients being severely frail. Higher education, income, dietary compliance, and physical activity were positively associated with self-care and adherence, whereas frailty was more common among women, individuals with low education, and those who were physically inactive. Structural equation modeling analysis suggested that self-care mediated the relationship between treatment adherence and frailty, accounting for 26.6% of the variance in frailty scores. Treatment adherence alone did not directly influence frailty in this study. CONCLUSIONS: In older adults with hypertension, self-care appeared to play an important role in frailty and mediated the impact of treatment adherence. Findings suggest that frailty in older adults with hypertension might be influenced by modifiable behavioral and cognitive self-care practices in addition to aging-related processes. Hypertension management in older adults might benefit from self-care-centered interventions alongside pharmacological adherence strategies, integration of frailty screening, and targeted support for high-risk groups.