Qian Fangfang, Zheng Guoqiang, Chen Zhuoming
Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, People's Republic of China.
Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, 613 West Huangpu Avenue, Guangzhuo, 510000, Guangdong Province, China.
Eur Arch Psychiatry Clin Neurosci. 2025 Sep 19. doi: 10.1007/s00406-025-02098-6.
This study employs bidirectional Mendelian randomization (MR) analysis to explore the causal relationship between frailty and common psychiatric disorders.
Depression, anxiety disorder, bipolar disorder, schizophrenia, sleep disorders, and eating disorders were considered as outcomes, with frailty index as the exposure variable. The main method employed was inverse variance weighting. Two-step MR was used to evaluate the mediation proportions of body mass index (BMI) between frailty and psychiatric disorders. Additionally, reverse MR analysis was conducted using the same testing methods.
Frailty index was positively associated with depression, anxiety disorder, bipolar disorder, sleep disorders, and eating disorders. Schizophrenia indicated no significant causal association. The effect of frailty index on the risk of sleep disorders, eating disorders, depression were all partially mediated by BMI, with mediation proportion of 24.40%, 14.23% and 5.22%. Reverse MR analysis revealed that depression increased the risk of frailty.
This study has supported the causal association of frailty with depression, anxiety disorder, bipolar disorder, sleep disorders, and eating disorders. Additionally, individuals diagnosed with depression exhibit a heightened susceptibility to frailty. This sheds new light on the causal relationship between frailty and psychiatric disorders.
本研究采用双向孟德尔随机化（MR）分析来探讨虚弱与常见精神障碍之间的因果关系。
将抑郁症、焦虑症、双相情感障碍、精神分裂症、睡眠障碍和饮食失调视为结局，将虚弱指数作为暴露变量。主要采用的方法是逆方差加权。采用两步MR来评估体重指数（BMI）在虚弱与精神障碍之间的中介比例。此外，使用相同的测试方法进行反向MR分析。
虚弱指数与抑郁症、焦虑症、双相情感障碍、睡眠障碍和饮食失调呈正相关。精神分裂症未显示出显著的因果关联。虚弱指数对睡眠障碍、饮食失调、抑郁症风险的影响均部分由BMI介导，中介比例分别为24.40%、14.23%和5.22%。反向MR分析显示抑郁症会增加虚弱风险。
本研究支持了虚弱与抑郁症、焦虑症、双相情感障碍、睡眠障碍和饮食失调之间的因果关联。此外，被诊断为抑郁症的个体表现出更高的虚弱易感性。这为虚弱与精神障碍之间的因果关系提供了新的见解。
