Frailty predicts new and persistent depressive symptoms among community-dwelling older adults: findings from Singapore longitudinal aging study.

OBJECTIVE

This study aimed to examine the cross-sectional and longitudinal relationships between physical frailty at baseline and depressive symptoms at baseline and at follow-up.

DESIGN

Four-year prospective study.

SETTING

Communities in the South East Region of Singapore.

PARTICIPANTS

We analyzed data of 1827 older Chinese adults aged 55 and above in the Singapore Longitudinal Aging Study-I.

MEASUREMENTS

The frailty phenotype (based on Fried criteria) was determined at baseline, depressive symptoms (Geriatric Depression Scale ≥ 5) at baseline and follow-ups at 2 and 4 years.

RESULTS

The mean age of the population was 65.9 (standard deviation 7.26). At baseline, 11.4% (n = 209) had depressive symptoms, 32.4% (n = 591) were prefrail and 2.5% (n = 46) were frail. In cross-sectional analysis of baseline data, the adjusted odds ratios (OR)s and 95% confidence intervals controlling for demographic, comorbidities, and other confounders were 1.69 (1.23-2.33) for prefrailty and 2.36 (1.08-5.15) for frailty, (P for linear trend <.001). In longitudinal data analyses, prospective associations among all participants were: prefrail: OR = 1.86 (1.08-3.20); frail: OR = 3.09 (1.12-8.50); (P for linear trend = .009). Among participants free of depressive symptoms at baseline, similar prospective associations were found: prefrail OR = 2.26 (1.12-4.57); frail: OR = 3.75 (1.07-13.16); (P for linear trend = .009).

CONCLUSION

These data support a significant role of frailty as a predictor of depression in a relatively younger old Chinese population. Further observational and interventional studies should explore short-term dynamic and bidirectional associations and the effects of frailty reversal on depression risk.