Yu Zhuling, Teng Yanbo, Peng Le
Huizhou First Hospital, Guangdong Medical University, Huizhou 516001, Guangdong, China.
Huizhou First Hospital, Guangdong Medical University, Huizhou 516001, Guangdong, China; Faculty of Medical Science, Jinan University, Guangzhou 510632, Guangdong, China.
Arch Gerontol Geriatr. 2025 Dec;139:106019. doi: 10.1016/j.archger.2025.106019. Epub 2025 Aug 29.
Frailty is a dynamic condition that may affect mental health. This study aimed to investigate the associations of frailty and its changes with the risks of depressive symptoms across multiple regions in aging populations.
Data were drawn from five cohort studies in the United States, England, Europe, China, and Mexico. Frailty was assessed by frailty index which included chronic diseases, vision and hearing impairments, pain, self-reported health status, activity of daily living, instrumental activity of daily living, mobility, and cognitive function. Changes in frailty were evaluated by frailty at baseline and the first follow-up survey. Unadjusted and adjusted hazard ratios (HRs) with 95% confidence intervals [CIs] were estimated by Cox proportional hazards models and then pooled by meta-analyses.
Of the 61,063 participants, 17,960 developed depressive symptoms during a median time of 5.9 to 9.0 years. Baseline frailty was significantly associated with an increased risk of depressive symptoms. Participants who changed from robust to pre-frail or frail status showed an elevated risk of depressive symptoms compared to stable robust participants (HR range: 1.38-1.81; pooled HR: 1.53, 95% CI: 1.37-1.72). Conversely, participants who transitioned from frail to robust or pre-frail status demonstrated a reduced risk of depressive symptoms compared to stable frail participants (HR range: 0.36-0.78; pooled HR: 0.71, 95% CI: 0.63-0.79).
Baseline frailty was associated with incident depressive symptoms. Deterioration of frailty elevated the risk of depressive symptoms, whereas improvement of frailty lowered the risk. This study suggests that timely interventions for frailty may prevent depressive symptoms.
衰弱是一种可能影响心理健康的动态状况。本研究旨在调查衰弱及其变化与老年人群多个地区抑郁症状风险之间的关联。
数据来自美国、英国、欧洲、中国和墨西哥的五项队列研究。通过衰弱指数评估衰弱，该指数包括慢性病、视力和听力障碍、疼痛、自我报告的健康状况、日常生活活动能力、工具性日常生活活动能力、 mobility和认知功能。通过基线时的衰弱情况和首次随访调查评估衰弱的变化。通过Cox比例风险模型估计未调整和调整后的风险比（HRs）及其95%置信区间[CIs]，然后通过荟萃分析进行汇总。
在61063名参与者中，17960人在中位时间5.9至9.0年期间出现了抑郁症状。基线衰弱与抑郁症状风险增加显著相关。与稳定的健康参与者相比，从健康转变为衰弱前期或衰弱状态的参与者出现抑郁症状的风险升高（HR范围：1.38 - 1.81；汇总HR：1.53，95% CI：1.37 - 1.72）。相反，与稳定的衰弱参与者相比，从衰弱转变为健康或衰弱前期状态的参与者出现抑郁症状的风险降低（HR范围：0.36 - 0.78；汇总HR：0.71，95% CI：0.63 - 0.79）。
基线衰弱与新发抑郁症状相关。衰弱的恶化会增加抑郁症状的风险，而衰弱的改善则会降低风险。本研究表明，及时干预衰弱可能预防抑郁症状。
