Relationship between depression and frailty in older adults: A systematic review and meta-analysis

• Published in: Ageing research reviews Vol. 36; pp. 78 - 87
• Main Authors: Soysal, Pinar, Veronese, Nicola, Thompson, Trevor, Kahl, Kai G., Fernandes, Brisa S., Prina, A. Matthew, Solmi, Marco, Schofield, Patricia, Koyanagi, Ai, Tseng, Ping-Tao, Lin, Pao-Yao, Chu, Che-Sheng, Cosco, Theodore D., Cesari, Matteo, Carvalho, Andre F., Stubbs, Brendon
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01.07.2017
• Subjects: Aged; Aged, 80 and over; Cross-Sectional Studies; Depression; Depression - diagnosis; Depression - epidemiology; Depression - psychology; Frail; Frail Elderly - psychology; Frailty - diagnosis; Frailty - epidemiology; Frailty - psychology; Geriatrics; Humans; Incidence; Internal Medicine; Meta-analysis; Neurology; Older adults; Prevalence; Psychiatry; Risk Factors; Depression; Older adults; Psychiatry; Frail; Geriatrics; Meta-analysis; older adults; meta-analysis; geriatrics; frail; depression; psychiatry
• ISSN: 1568-1637; 1872-9649; 1872-9649
• DOI: 10.1016/j.arr.2017.03.005

•Depression and frailty are two common and pervasive conditions in older age.•We conducted the first meta-analysis exploring the relationship between these constructs.•In cross-sectional studies, participants with frailty had fourfold increased odds of depression.•People with depression were at approximately fourfold increased odds of having frailty.•Pooled data from longitudinal studies confirmed the heighted risk of comorbidity. Depression and frailty are prevalent and burdensome in older age. However, the relationships between these entities are unclear and no quantitative meta- analysis exists. We conducted a systematic review and meta-analysis to investigate the associations between depression and frailty. Two authors searched major electronic databases from inception until November-2016 for cross-sectional/longitudinal studies investigating depression and frailty. The strength of the reciprocal associations between frailty and depression was assessed through odds ratios (ORs) adjusted for potential confounders. From 2306 non duplicated hits, 24 studies were included. The overall prevalence of depression in 8023 people with frailty was 38.60% (95% CI 30.07–47.10, I2=94%). Those with frailty were at increased odds of having depression (OR adjusted for publication bias 4.42, 95%CI 2.66–7.35, k=11), also after adjusting for potential confounders (OR=2.64; 95%CI: 1.59–4.37, I2=55%, k=4). The prevalence of frailty in 2167 people with depression was 40.40% (95%CI 27.00–55.30, I2=97%). People with depression were at increased odds of having frailty (OR=4.07, 95%CI 1.93–8.55, k=8). The pooled OR for incident frailty, adjusted for a median of 7 confounders, was 3.72 (95%CI 1.95–7.08, I2=98%, k=4), whilst in two studies frailty increased the risk of incident depression with an OR=1.90 (95%CI 1.55–2.32, I2=0%). This meta-analysis points to a reciprocal interaction between depression and frailty in older adults. Specifically, each condition is associated with an increased prevalence and incidence of the other, and may be a risk factor for the development of the other. However, further prospective investigations are warranted.