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

Abstract

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.

Keywords: Physical frailty; comorbidity; depression; outcome; risk factor.