Key Laboratory of Arrhythmias of the Ministry of Education of China, Tongji University School of Medicine, Shanghai, China.
Rugao People's Hospital, Rugao, China.
Psychogeriatrics. 2021 Jul;21(4):483-490. doi: 10.1111/psyg.12696. Epub 2021 May 6.
To explore the cross-sectional and longitudinal associations between social frailty (SF) and incident depressive symptoms in a Chinese population.
SF was measured with 6 questions (6 points maximum; 0-1 = non-SF, 2-3 = pre-SF, 4-6 = SF). Depressive symptoms were defined as a score of ≥6 on the Geriatric Depression Scale. Compared to baseline, participants with a ≥2-point increase in the Geriatric Depression Scale score were considered to have worsening depressive symptoms.
At baseline, among 1764 participants, 9.9% (n = 175) had depressive symptoms, 3.6% (n = 61) were SF, and 38.2% (n = 650) were pre-SF. The percentage of depressive symptoms increased with SF status from 5.1% (non-SF) to 12.9% (pre-SF), to 41.0% (SF). In cross-sectional analysis, after adjustments for multiple covariates, depressive symptoms were significantly associated with both pre-SF (odds ratio (OR) = 2.94, 95% confidence interval (CI) 2.01-4.32) and SF (OR = 16.70, 95% CI 8.80-31.71). During the 3-year follow-up period, 10.0% (n = 117) of the participants developed depressive symptoms. In longitudinal analyses, after multiple adjustments, SF and pre-SF were associated with a 2.31-fold (95% CI 1.10-4.88) and 1.58-fold (95% CI 1.05-2.38) increased risk of incidence of depressive symptoms, respectively. Among participants without depressive symptoms at baseline, 23.2% had worsening depressive symptoms, and SF was associated with increased risk of worsening depressive symptoms (OR = 2.07, 95% CI 1.18-3.65).
Our findings suggested that SF may be a predictor of depression among Chinese community-dwelling older adults. In addition, in elders with no depressive symptoms at baseline, those with SF had greater odds of worsening depressive symptoms 3 years later.
探索中国人群中社会脆弱性（SF）与新发抑郁症状的横断面和纵向关联。
使用 6 个问题（最高 6 分；0-1=非 SF，2-3=预 SF，4-6=SF）测量 SF。抑郁症状定义为老年抑郁量表评分≥6。与基线相比，老年抑郁量表评分增加≥2 分者被认为有抑郁症状恶化。
在基线时，1764 名参与者中，9.9%（n=175）有抑郁症状，3.6%（n=61）为 SF，38.2%（n=650）为预 SF。SF 状态从非 SF（5.1%）到预 SF（12.9%）再到 SF（41.0%），抑郁症状的比例逐渐增加。在横断面分析中，在校正多个协变量后，抑郁症状与预 SF（比值比（OR）=2.94，95%置信区间（CI）2.01-4.32）和 SF（OR=16.70，95% CI 8.80-31.71）显著相关。在 3 年随访期间，10.0%（n=117）的参与者出现了抑郁症状。在纵向分析中，经过多次调整后，SF 和预 SF 与新发抑郁症状的风险增加 2.31 倍（95% CI 1.10-4.88）和 1.58 倍（95% CI 1.05-2.38）相关。在基线时无抑郁症状的参与者中，有 23.2%出现抑郁症状恶化，SF 与抑郁症状恶化风险增加相关（OR=2.07，95% CI 1.18-3.65）。
我们的研究结果表明，SF 可能是中国社区居住的老年人发生抑郁的一个预测因素。此外，在基线时无抑郁症状的老年人中，SF 者出现抑郁症状恶化的可能性更大。
