Frailty and incident depressive symptoms in a Chinese sample: the Rugao Longevity and Ageing Study

Chu, Xuefeng; Zhang, Na; Shi, Guo‐Ping; Wang, Yong; Wang, Zhengdong; Guo, Jianghong; Jiang, Xiaoyan; Jin, Li; Zhu, Yin‐Sheng

doi:10.1111/psyg.12565

Cited by 11 publications

(14 citation statements)

References 20 publications

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“…Several findings from longitudinal studies have found that factors similar to components of frailty, such as physical activity ( 32 , 33 ), fatigue ( 34 – 36 ) and mobility impairment ( 37 ) appear to increase the risk for developing depressive symptoms in the older adult. Findings from the present longitudinal data in our study indicate that preferability/frailty is associated with increased risk of incident depressive symptoms after 4 years of follow-up in the middle-aged and elderly aged 45–96 years was in line with the previous studies conducted in the United Kingdom ( 22 ), Japan ( 38 ), Italians ( 39 ), and mainland China ( 22 , 40 – 42 ), although the measurements of the frailty phenotype, the population and the years of follow-up were different. Interestingly, we did not find a significant association between baseline preferability/frailty and the longitudinal onset of depressive symptoms after 2 years of follow-up.…”

Section: Discussionsupporting

confidence: 93%

“…Collard et al ( 39 ) launched another similar study to discuss the association and found that Low physical activity was associated with incident depressive symptoms. Chu et al ( 42 ) conducted a population-based cohort study including 1,788 older adults aged 70–84 years in Rugao, Jiangsu Province, China and found that weakness (lower grip strength) was associated with incident depressive symptoms. Several hypotheses could be used to explain the differences between our study and the previously mentioned studies in the literature.…”

Section: Discussionmentioning

confidence: 99%

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Frailty and Incident Depressive Symptoms During Short- and Long-Term Follow-Up Period in the Middle-Aged and Elderly: Findings From the Chinese Nationwide Cohort Study

Liu

Xu²,

Guo

et al. 2022

Front. Psychiatry

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ObjectivePrefrailty and frailty are two common conditions among older individuals. Recent studies have reported the association between frailty and depressive symptoms, but whether those conditions could predict depressive symptoms is still inconsistent in a few longitudinal studies. In our study, we aimed to estimate the cross-sectional and longitudinal associations between frailty and incident depressive symptoms in a nationally representative sample of community-dwelling middle-aged and older Chinese adults.MethodData were obtained from the China Health and Retirement Longitudinal Study (CHARLS), which included 17,284 adults aged ≥ 45 years. Participants were followed every two years using a face-to-face, computer-aided personal interview (CAPI) and structured questionnaire. We excluded participants with no follow-up data. The numbers of individuals who completed the baseline surveys were 2,579 and follow-up surveys were 839 for the short-term (2 years from 2011 to 2013) and 788 for the long-term (4 years from 2011 to 2015). In addition, Frailty was measured by the Fried criteria and depressive symptoms were estimated by the Chinese version of the Center for Epidemiologic Studies-Depression scale (CES-D). Logistic regression was used to analyze the odds ratio (OR), and 95% confidence interval (CI) for the cross-sectional associations of frailty and its components with depressive symptoms in the participants at baseline. Cox proportional hazards analysis was conducted using the hazard ratio (HR), and 95% confidence interval (CI) for the prospective associations of baseline frailty and pre-frailty and its component in the participants without depressive symptoms at baseline.ResultsAt baseline, 57.93% of participants had depressive symptoms and 55.84% had pre-frail and 11.63% had frailty. In the cross-sectional analysis, both pre-frailty (OR = 5.293, 95%CI 4.363–6.422) and frailty (OR = 16.025, 95%CI 10.948–23.457) were associated with depressive symptoms. In the longitudinal analysis, frailty [HR = 1.395 (0.966–2.013)] and pre-frailty [HR = 2.458 (0.933, 6.479)] were not significantly associated with incident depressive symptoms in a full-adjusted model among participants free of baseline depressive symptoms during the short-term. However, frailty [HR = 1.397 (1.017, 1.920)] and pre-frailty [HR = 2.992 (1.210, 7.397)] were significantly associated with incident depressive symptoms during the short term. In the components of frailty, slowness [HR = 1.597 (1.078, 2.366)] was associated with an increased risk of depressive symptoms onset during the short-term. Weakness [HR = 2.08 (1.055, 4.104)] and exhaustion [HR = 1.928 (1.297, 2.867)] were associated with increased risk of depressive symptoms onset during the short-term.ConclusionAmong the middle-aged and older adults, frailty, pre-frailty did not predict depressive symptoms during 2 years of follow-up, when accounting for the potential confounders, slowness considered alone predicted depressive symptoms. Additionally, frailty, pre-frailty predicted depressive symptoms during 4 years of follow-up, when accounting for the potential confounders, weakness and exhaustion considered alone predicted depressive symptoms.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Frailty and Incident Depressive Symptoms During Short- and Long-Term Follow-Up Period in the Middle-Aged and Elderly: Findings From the Chinese Nationwide Cohort Study

Liu

Xu²,

Guo

et al. 2022

Front. Psychiatry

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“…Chu and colleagues (54) also confirmed that frailty (measured by Fried frailty phenotype) was associated with depressive symptoms (measured by GDS) after longitudinal analyses (OR = 2.12, 95% CI = 1.17-3.83), considering the adjusted models. As previously mentioned (52,54), the same cohort study investigated the relationship between depressive symptoms and frailty reciprocally, which reinforces the bidirectional association between both conditions. However, the current study extends to the findings of these studies that depressive disorders (mainly MDD) also predicts the onset of frailty.…”

Section: Main Findingsmentioning

confidence: 57%

Longitudinal Association between Late-Life Depression (LLD) and Frailty: Findings from a Prospective Cohort Study (MiMiCS-FRAIL)

Borges

Romanini

Lima

et al. 2021

The Journal of nutrition, health and aging

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OBJECTIVES:The aim of the present study was to investigate whether late-life depression (LLD) is associated with incident frailty over time. DESIGN: Prospective cohort study, one-year follow-up. SETTING: Geriatric outpatient clinic, Southwestern of Brazil. PARTICIPANTS: 181 follow-up participants aged 60 years or over. MEASUREMENTS: Depressive disorders were classified as Major Depressive disorder (MDD) or Subthreshold Depression (STD) according to DSM-5 criteria. Depressive symptoms were assessed with validated versions of 15-item Geriatric Depression Scale (GDS-15) and 9-item Patient Health Questionnaire (PHQ-9). We performed binary logistic regressions to estimate the odds ratio (OR) for frailty in LLD adjusting for multiple confounders. Participants who were frail at baseline were excluded from the analyses according to measures of frailty (FRAIL questionnaire and 36-item Frailty Index, FI-36). We also estimated the risk ratio or relative risk (RR) and the risk difference (RD) for incident frailty. RESULTS: We observed a 2 to 4-fold increased risk for incident frailty among participants with LLD. The presence of a depressive disorder was significantly associated with the onset of frailty (adjusted OR for FRAIL and FI-36: 3.07 [95% CI = 1.03 -9.17] and 3.76 [95% CI = 1.09 -12.97], respectively. Notably, the risk for frailty due to LLD was significantly higher with the FI-36 compared to the FRAIL (RR: 3.03 versus 2.23). RD was of 17.3% and 12.7% with the FRAIL and the FI-36, respectively. CONCLUSION: Our data support the association between LLD and incident frailty over one year among geriatric outpatients, reinforcing longitudinal evidence from population-based studies.

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“…Pessoas idosas frágeis podem desenvolver mais facilmente os SD devido ao comprometimento da funcionalidade, baixa atividade física e atividades sociais. Em nível molecular, pessoas idosas frágeis podem ter aumentado níveis de inflamação de baixo grau, como aumento citocinas de interleucina-6, proteína C reativa ou fator de necrose tumoral-α, que podem agir como como moderados do risco do início dos SD 11,25 .…”

Section: Métodounclassified

“…Assim como os marcadores, a condição de fragilidade também foi investigada na ralação transversal e longitudinal em estudo realizado na China com 1.264 pessoas idosas. Verificaram-se associações entre a condição de pré-frágil e frágil, além do marcador força de preensão manual com a ocorrência de SD nas pessoas idosas 11 .…”

Section: Introductionunclassified

Marcadores de fragilidade física preditivos de sintomas depressivos em pessoas idosas da atenção primária à saúde

Barbiero

Lenardt

Betiolli

et al. 2021

Rev. bras. geriatr. gerontol.

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Resumo Objetivo identificar quais os marcadores de fragilidade física predizem os sintomas depressivos (SD) em pessoas idosas assistidas na Atenção Primária à Saúde. Método estudo quantitativo de corte transversal e correlacional desenvolvido em uma Unidade Básica de Saúde em Curitiba, (PR), Brasil, com amostra de 389 pessoas idosas. Coletaram-se os dados de janeiro a outubro de 2019, por meio de questionário sociodemográfico e clínico, escala de depressão (Center for Epidemiological Studies) e testes que compõem o fenótipo da fragilidade física. Para as análises, utilizou-se estatística descritiva, inferencial (qui-quadrado de Pearson), nível de significância de p≤0,05), e regressão logística reportado a estimativa, valor p (teste de Wald). Razão de Prevalência com intervalo de confiança 95%. Resultados das 389 pessoas idosas, 103 (26,5%) apresentaram SD; entre eles 63 (61,2%) eram pré-frágeis, 19 (18,4%) frágeis e 21 (20,4%) não frágeis. Associaram-se aos SD os marcadores fadiga/exaustão (p≤0,001), redução do nível de atividade física (p≤0,001), perda de peso não intencional (p=0,003) e a condição de pré-fragilidade e fragilidade (p≤0,001). O modelo preditivo para os SD incluiu os marcadores fadiga/exaustão (RP: 5,12; IC95%; 3,81-6,87; p<0,0001) e redução do nível de atividade física (RP: 2,16, IC95%; 1,45- 3,22; p<0,0001). Conclusão os marcadores do fenótipo fadiga/exaustão e redução da atividade física são preditores dos SD em pessoas idosas. Esse resultado ressalta a importância e a necessidade da avaliação desses marcadores e da efetividade de ações para o combate ao sedentarismo em pessoas idosas da atenção primária à saúde.

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Frailty and incident depressive symptoms in a Chinese sample: the Rugao Longevity and Ageing Study

Cited by 11 publications

References 20 publications

Frailty and Incident Depressive Symptoms During Short- and Long-Term Follow-Up Period in the Middle-Aged and Elderly: Findings From the Chinese Nationwide Cohort Study

Frailty and Incident Depressive Symptoms During Short- and Long-Term Follow-Up Period in the Middle-Aged and Elderly: Findings From the Chinese Nationwide Cohort Study

Longitudinal Association between Late-Life Depression (LLD) and Frailty: Findings from a Prospective Cohort Study (MiMiCS-FRAIL)

Marcadores de fragilidade física preditivos de sintomas depressivos em pessoas idosas da atenção primária à saúde

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