| Citizen-Led Integrated Care in Depopulated Rural Areas: Addressing Depression and Frailty in Older Adults |
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Suhyeon Choi1, Susan Park2, Eunhee Choi3, Jihee Choi3, Minkyoung Kim4, Seok-gyu Kim3, Sunyoung Park1, Soong-nang Jang5 |
1Department of Nursing, Graduate School, Chung-Ang University, Seoul, Republic of Korea
2Deparment of Medicine, Inha University, Incheon, Republic of Korea
3Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
4Institute of Development Studies, University of Sussex, Brighton, UK
5Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea |
Correspondence:
Soong-nang Jang,
Email: sjang@cau.ac.kr
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Received: 29 October 2025 • Revised: 9 December 2025 • Accepted: 11 December 2025 |
| Abstract |
Background
Rural areas in South Korea are experiencing both super-aging and depopulation, creating critical gaps in health and social care. Using a citizen participatory approach, we sought to address the care gaps by older adults in rural areas. This study examined the changes in frailty and depressive symptoms observed during a citizen-led intervention.
Methods
This study is a single-arm pre–post quasi-experimental design. A 12-week intervention was implemented using local citizens as care providers. Intervention components included identifying and planning individual care needs, providing health education, organizing tailored community activities, and conducting AI-assisted weekly check-up calls to monitor health status.
Results
Changes appeared more pronounced among vulnerable subgroups. Older adults with frailty showed an observed decrease in depressive symptoms compared to those with prefrailty or robust status. Conversely, among those with depressive symptoms, frailty levels appeared to increase more slowly than those without depressive symptoms. These patterns are consistent with the previously reported bidirectional associations between frailty and depression and may reflect the tendency for changes in one domain to coincide with changes in the other, rather than indicating a causal influence.
Conclusion
This citizen-led care intervention showed more noticeable short-term chnages among older adults with higher vulnerability, particularly those with frailty or depressive symptoms. These findings indicate potential roles for citizen participation in enhancing social support and supporting ongoing monitoring in depopulated rural areas. The results suggest that citizen participation as a potentially feasible and sustainable approach whining care systems in aging, resource-limited communities. |
| Key Words:
Rural Population, frailty, depression, Citizen Science |
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