Association of coexistence of frailty and depressive symptoms with mortality in community-dwelling older adults: Kashiwa Cohort Study

Shota Hamada; Yui Sasaki; Bo Kyung Son; Tomoki Tanaka; Weida Lyu; Rumiko Tsuchiya-Ito; Satomi Kitamura; Alex Dregan; Matthew Hotopf; Masao Iwagami; Katsuya Iijima

doi:10.1016/j.archger.2023.105322

Association of coexistence of frailty and depressive symptoms with mortality in community-dwelling older adults: Kashiwa Cohort Study

Shota Hamada^*, Yui Sasaki, Bo Kyung Son, Tomoki Tanaka, Weida Lyu, Rumiko Tsuchiya-Ito, Satomi Kitamura, Alex Dregan, Matthew Hotopf, Masao Iwagami, Katsuya Iijima

^*Corresponding author for this work

Psychological Medicine

Research output: Contribution to journal › Article › peer-review

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Abstract

Objectives: This study aimed to determine the longitudinal associations of the coexistence of frailty and depressive symptoms with mortality among older adults. Methods: The study participants were community-dwelling older adults aged ≥65 years who participated in the baseline survey of the Kashiwa Cohort Study in Japan in 2012. We used Fried's frailty phenotype criteria to classify participants as non-frail (score = 0), pre-frail (1 or 2), or frail (≥3). Depressive symptoms were assessed using the GDS-15 (≥6 points). Cox proportional hazards models were used to evaluate the association of co-occurring frailty and depressive symptoms with all-cause mortality, after adjusting for sociodemographic and clinical characteristics. Results: The study included 1920 participants, including 810 non-frail, 921 pre-frail, and 189 frail older adults, of which 9.0 %, 15.7 %, and 36.0 %, respectively, had depressive symptoms. Ninety-one (4.7 %) participants died during the average follow-up period of 4.8 years. Compared with non-frail participants without depressive symptoms, frail participants had greater adjusted hazard ratios for mortality: 2.47 (95 % CI, 1.16 to 5.25) for frail participants without depressive symptoms and 4.34 (95 % CI, 1.95 to 9.65) for frail participants with depressive symptoms. However, no statistically significant associations were observed in non-frail or pre-frail participants irrespective of depressive symptoms. Conclusion: Frail older adults with depressive symptoms have a substantially greater risk of mortality. Screening for depressive symptoms and frailty in older adults should be incorporated into health checkups and clinical practice to identify high-risk populations.

Original language	English
Article number	105322
Journal	ARCHIVES OF GERONTOLOGY AND GERIATRICS
Volume	119
Early online date	4 Jan 2024
DOIs	https://doi.org/10.1016/j.archger.2023.105322
Publication status	Published - Apr 2024

Keywords

Depression
Depressive symptoms
Frailty
Mortality

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Hamada, S., Sasaki, Y., Son, B. K., Tanaka, T., Lyu, W., Tsuchiya-Ito, R., Kitamura, S., Dregan, A., Hotopf, M., Iwagami, M., & Iijima, K. (2024). Association of coexistence of frailty and depressive symptoms with mortality in community-dwelling older adults: Kashiwa Cohort Study. ARCHIVES OF GERONTOLOGY AND GERIATRICS, 119, Article 105322. https://doi.org/10.1016/j.archger.2023.105322

@article{dd1121de943b4c32ad07a7639776eed8,

title = "Association of coexistence of frailty and depressive symptoms with mortality in community-dwelling older adults: Kashiwa Cohort Study",

abstract = "Objectives: This study aimed to determine the longitudinal associations of the coexistence of frailty and depressive symptoms with mortality among older adults. Methods: The study participants were community-dwelling older adults aged ≥65 years who participated in the baseline survey of the Kashiwa Cohort Study in Japan in 2012. We used Fried's frailty phenotype criteria to classify participants as non-frail (score = 0), pre-frail (1 or 2), or frail (≥3). Depressive symptoms were assessed using the GDS-15 (≥6 points). Cox proportional hazards models were used to evaluate the association of co-occurring frailty and depressive symptoms with all-cause mortality, after adjusting for sociodemographic and clinical characteristics. Results: The study included 1920 participants, including 810 non-frail, 921 pre-frail, and 189 frail older adults, of which 9.0 %, 15.7 %, and 36.0 %, respectively, had depressive symptoms. Ninety-one (4.7 %) participants died during the average follow-up period of 4.8 years. Compared with non-frail participants without depressive symptoms, frail participants had greater adjusted hazard ratios for mortality: 2.47 (95 % CI, 1.16 to 5.25) for frail participants without depressive symptoms and 4.34 (95 % CI, 1.95 to 9.65) for frail participants with depressive symptoms. However, no statistically significant associations were observed in non-frail or pre-frail participants irrespective of depressive symptoms. Conclusion: Frail older adults with depressive symptoms have a substantially greater risk of mortality. Screening for depressive symptoms and frailty in older adults should be incorporated into health checkups and clinical practice to identify high-risk populations.",

keywords = "Depression, Depressive symptoms, Frailty, Mortality",

author = "Shota Hamada and Yui Sasaki and Son, {Bo Kyung} and Tomoki Tanaka and Weida Lyu and Rumiko Tsuchiya-Ito and Satomi Kitamura and Alex Dregan and Matthew Hotopf and Masao Iwagami and Katsuya Iijima",

note = "Funding Information: None. Publisher Copyright: {\textcopyright} 2023",

year = "2024",

month = apr,

doi = "10.1016/j.archger.2023.105322",

language = "English",

volume = "119",

journal = "ARCHIVES OF GERONTOLOGY AND GERIATRICS",

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Hamada, S, Sasaki, Y, Son, BK, Tanaka, T, Lyu, W, Tsuchiya-Ito, R, Kitamura, S, Dregan, A , Hotopf, M, Iwagami, M & Iijima, K 2024, 'Association of coexistence of frailty and depressive symptoms with mortality in community-dwelling older adults: Kashiwa Cohort Study', ARCHIVES OF GERONTOLOGY AND GERIATRICS, vol. 119, 105322. https://doi.org/10.1016/j.archger.2023.105322

TY - JOUR

T1 - Association of coexistence of frailty and depressive symptoms with mortality in community-dwelling older adults

T2 - Kashiwa Cohort Study

AU - Hamada, Shota

AU - Sasaki, Yui

AU - Son, Bo Kyung

AU - Tanaka, Tomoki

AU - Lyu, Weida

AU - Tsuchiya-Ito, Rumiko

AU - Kitamura, Satomi

AU - Dregan, Alex

AU - Hotopf, Matthew

AU - Iwagami, Masao

AU - Iijima, Katsuya

PY - 2024/4

Y1 - 2024/4

N2 - Objectives: This study aimed to determine the longitudinal associations of the coexistence of frailty and depressive symptoms with mortality among older adults. Methods: The study participants were community-dwelling older adults aged ≥65 years who participated in the baseline survey of the Kashiwa Cohort Study in Japan in 2012. We used Fried's frailty phenotype criteria to classify participants as non-frail (score = 0), pre-frail (1 or 2), or frail (≥3). Depressive symptoms were assessed using the GDS-15 (≥6 points). Cox proportional hazards models were used to evaluate the association of co-occurring frailty and depressive symptoms with all-cause mortality, after adjusting for sociodemographic and clinical characteristics. Results: The study included 1920 participants, including 810 non-frail, 921 pre-frail, and 189 frail older adults, of which 9.0 %, 15.7 %, and 36.0 %, respectively, had depressive symptoms. Ninety-one (4.7 %) participants died during the average follow-up period of 4.8 years. Compared with non-frail participants without depressive symptoms, frail participants had greater adjusted hazard ratios for mortality: 2.47 (95 % CI, 1.16 to 5.25) for frail participants without depressive symptoms and 4.34 (95 % CI, 1.95 to 9.65) for frail participants with depressive symptoms. However, no statistically significant associations were observed in non-frail or pre-frail participants irrespective of depressive symptoms. Conclusion: Frail older adults with depressive symptoms have a substantially greater risk of mortality. Screening for depressive symptoms and frailty in older adults should be incorporated into health checkups and clinical practice to identify high-risk populations.

AB - Objectives: This study aimed to determine the longitudinal associations of the coexistence of frailty and depressive symptoms with mortality among older adults. Methods: The study participants were community-dwelling older adults aged ≥65 years who participated in the baseline survey of the Kashiwa Cohort Study in Japan in 2012. We used Fried's frailty phenotype criteria to classify participants as non-frail (score = 0), pre-frail (1 or 2), or frail (≥3). Depressive symptoms were assessed using the GDS-15 (≥6 points). Cox proportional hazards models were used to evaluate the association of co-occurring frailty and depressive symptoms with all-cause mortality, after adjusting for sociodemographic and clinical characteristics. Results: The study included 1920 participants, including 810 non-frail, 921 pre-frail, and 189 frail older adults, of which 9.0 %, 15.7 %, and 36.0 %, respectively, had depressive symptoms. Ninety-one (4.7 %) participants died during the average follow-up period of 4.8 years. Compared with non-frail participants without depressive symptoms, frail participants had greater adjusted hazard ratios for mortality: 2.47 (95 % CI, 1.16 to 5.25) for frail participants without depressive symptoms and 4.34 (95 % CI, 1.95 to 9.65) for frail participants with depressive symptoms. However, no statistically significant associations were observed in non-frail or pre-frail participants irrespective of depressive symptoms. Conclusion: Frail older adults with depressive symptoms have a substantially greater risk of mortality. Screening for depressive symptoms and frailty in older adults should be incorporated into health checkups and clinical practice to identify high-risk populations.

KW - Depression

KW - Depressive symptoms

KW - Frailty

KW - Mortality

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U2 - 10.1016/j.archger.2023.105322

DO - 10.1016/j.archger.2023.105322

M3 - Article

C2 - 38171032

AN - SCOPUS:85181819178

SN - 0167-4943

VL - 119

JO - ARCHIVES OF GERONTOLOGY AND GERIATRICS

JF - ARCHIVES OF GERONTOLOGY AND GERIATRICS

M1 - 105322

ER -

Association of coexistence of frailty and depressive symptoms with mortality in community-dwelling older adults: Kashiwa Cohort Study

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