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

Soysal, Pinar and Veronese, Nicola and Thompson, Trevor and Kahl, Kai G. and Fernandes, Brisa S. and Prina, Matthew and Solmi, Marco and Schofield, Patricia and Koyanagi, Ai and Tseng, Ping-Tao and Lin, Pao-Yao and Chu, Che-Sheng and Cosco, Theodore D. and Cesari, Matteo and Carvalho, Andre F. and Stubbs, Brendon (2017) Relationship between depression and frailty in older adults: A systematic review and meta-analysis. Ageing Research Reviews, 36. pp. 78-87. ISSN 1872-9649

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Aim: 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. Methods: 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. Results: 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%). Conclusion: 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.

Item Type: Journal Article
Keywords: depression, frail, geriatrics, older adults, meta-analysis, psychiatry
Faculty: ARCHIVED Faculty of Health, Social Care & Education (until September 2018)
Depositing User: Brendon Stubbs
Date Deposited: 03 Apr 2017 09:36
Last Modified: 09 Sep 2021 18:58

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