The Relationship Between Depression and Frailty in Community‐Dwelling Older People: A Systematic Review and Meta‐Analysis of 84,351 Older Adults

Abstract

Objectives In this study we investigated the correlation between depression and frailty in older adults. Additionally, correlations among study designs (prospective vs. cross‐sectional), regions, depression indices, frailty indices, covariance corrections, and sexes were explored to support the analysis. Methods A systematic literature review and meta‐analysis were conducted. A total of 84,351 older adults, all 65 years of age or older, were analyzed. Both authors independently extracted and examined retrieved articles. Searched keywords included “depression” or “depressive”; “frailty” or “frail”; and “older people,” “elderly,” “geriatric,” or “senior.” Articles published between January 2000 and December 2016 were searched. A literature quality assessment was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Systematic literature searches were conducted on the Embase, PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library databases, and collected studies were analyzed using a random effects model. Results Fourteen studies on people 65 years of age or older were collected, and a correlation analysis was conducted for depression and frailty. According to the meta‐analysis, the risk for frailty due to depression was nonsignificant among the subgroups for study design (p for heterogeneity = .149), region (p = .429), depression criteria (p = .934), covariate adjustment (p = .702), and frailty criteria (p = .661). Notably, the risk for frailty due to depression was significantly higher in men than in women (pooled odds ratios for men and women: 4.76 and 2.25, respectively; Qbetween χ2 = 9.93, p = .002). Conclusion Older adults with depression are more prone to frailty than are those without depression. Regardless of study design, region, depression index, frailty index, and covariance corrections, no significant differences were observed in the results of studies on depression and frailty in older adults. The only factor that had a significant influence was sex; older men with depression were at a higher risk for frailty than were older women with depression. Clinical Relevance Depression and frailty are pertinent health concerns related to geriatric syndromes. Because older adults with depression have a high risk for frailty, nursing personnel should use a depression index as early as possible to screen for depression and further reduce the occurrence of frailty in older adults. Furthermore, based on the aforementioned differences between the sexes, special attention should be paid to older men with depression to reduce their risk for frailty.

Physical Frailty and Its Associated Factors Among Elderly Nursing Home Residents in China

“…The possible explanation could be that older people who had been living in a private institution (more expensive in the metropolitan areas than public institution) usually have higher social economic status; they were more likely to feel lonely [30] and loss of appetite [31] when staying away from family and changing their ways of previous life, resulting in higher likelihood of being frailer. Compared with people living with their partners in the same nursing home, those who live with alone or share the room with unknown person may become more frail because of poorer social ties [32] and mental disorders [33]. In line with previous studies [34,35], we also found that regular exercise was associated with physical frailty.…”

Physical frailty and its associated factors among elderly nursing home residents in China

“…One possible explanation could be that older adults living in private institutions (more expensive in the metropolitan areas than public institutions) usually have higher social economic status, are perhaps more likely to feel more lonely [ 13 ] and suffer loss of appetite [ 33 ] when staying away from family and changing their ways of previous life, resulting in higher likelihood of being frailer. Compared with people living with their partners in the same nursing home, those who live with alone or share the room with unknown person may become more frail because of poorer social ties [ 34 ] and mental disorders [ 35 ]. In line with previous studies [ 36 , 37 ], we also found that regular exercise was associated with physical frailty.…”

<p>Simultaneous Employment of the FRAIL Scale and the Tilburg Frailty Indicator May Identify Elderly People Who Require Different Interventional Strategies</p>

“…The Tilburg Frailty Indicator (TFI) and adequately treated in order to improve people's mood and their motivation for an active life. [23][24][25] Poor social life is one of the principal reasons for low quality of life in elderly people, and loneliness seems to be an independent predictor for their functional deterioration and mortality. 22,[26][27][28][29][30] Furthermore, for the frail elderly individuals, social relationship is the most important factor for their existence, while non-frail older subjects consider health as the most critical one.…”