title: 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.
  
  
  METHODS
  Four-year prospective study.
  
  
  METHODS
  Communities in the South East Region of Singapore.
  
  
  METHODS
  We analyzed data of 1827 older Chinese adults aged 55 and above in the Singapore Longitudinal Aging Study-I.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors: Gerontology Research Program, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors: Liang
authors: L
authors: Feng
authors: Gerontology Research Program, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors: Ma Shwe Zin
authors: MS
authors: Nyunt
authors: Gerontology Research Program, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors: Lei
authors: L
authors: Feng
authors: Geriatric Medicine Department, Alexandra Hospital, Ministry of Health, Singapore.
authors: Keng Bee
authors: KB
authors: Yap
authors: Gerontology Research Program, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: pcmngtp@nus.edu.sg.
authors: Tze Pin
authors: TP
authors: Ng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D016330:Frail Elderly; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology
keywords: Physical frailty; comorbidity; depression; outcome; risk factor