Table 1.
Community-based cross-sectional studies of the relationship between frailty and depression
| First author | Year | Sample characteristics | Measure of frailty | Measure of depression |
Main findings |
|---|---|---|---|---|---|
| Frailty as determinant, depression as outcome | |||||
| Mirowsky | 1992 | USA | IADL index | CES-D | Physical dysfunction was significantly associated with depressive symptoms. |
| n = 2840 | |||||
| Age range: 18–90 years | |||||
| Gender & racial composition unknown | |||||
| Davidson | 1994 | USA | ADL index | CES-D | Functional limitations were significantly associated with the somatic, but not negative affect, positive affect, or interpersonal subscales of the CESD. |
| n = 303 | |||||
| Age range: 65–102 years | |||||
| 85% women | |||||
| 47% White | |||||
| Newsom | 1996 | USA | IADL index | CES-D | Functional impairment was associated with depressive symptoms. This relationship was partially mediated by social support. |
| n = 4734 | Exercise tolerance | ||||
| Mean age: 72.8 years | Upper extremity strength | ||||
| 57% women | |||||
| 95% White; 5% Black | Timed walk | ||||
| Broe | 1999 | Australia | CES-D | Gait slowing was positively associated with depressive symptoms. Association between chronic conditions and depression was mediated by disability. |
|
| n = 434 | Life Satisfaction Index-A | ||||
| Mean age: 80.6 years (SD: 4.0) | Medical/neurological assessment |
||||
| 46% women | |||||
| Racial composition unknown | |||||
| Hybels | 2001 | USA | Modified ADL index | CES-D | Functional limitations were associated with both sub- syndromal and severe depression syndrome. |
| n = 4162 | |||||
| 62% women | |||||
| Age range: 65–105 years | Weighted sum of chronic health conditions |
||||
| 66% White; 34% Black | |||||
| Jang | 2002 | USA | Katz ADL index | GDS | Disability status was associated with depression. |
| n = 406 | This relationship was moderated by sense of mastery. | ||||
| 52% women | IADL index | ||||
| Age range: 60–84 years | Physical Performance Scale | ||||
| 98% White | Functional Health Scale | ||||
| Cummings | 2003 | USA | ADL and IADL indices | CES-D | Functional impairment was not significantly associated with depression after accounting for social support and religiosity. |
| n = 568 | |||||
| 81% women | |||||
| Mean age: 70.7 years (SD: 6.7) | |||||
| 68% White; 32% Black | |||||
| Stek | 2004 | Netherlands | GARS | GDS | Functional limitations were associated with elevated depressive symptoms. |
| n = 500 | |||||
| 63% women | |||||
| Mean age: 85 years | |||||
| Racial composition unknown | |||||
| Jang | 2006 | USA | Physical Performance Scale | CES-D | Functional disability was associated with depressive symptoms. This association was mediated by health perceptions. |
| n = 230 | |||||
| 59% women | |||||
| Functional Health Scale | |||||
| Age range: 60–92 years | |||||
| 100% Asian | |||||
| Wada | 2008 | Japan | History of falling |
GDS | History of falling was positively associated with depressive symptoms. |
| n = 1261 | |||||
| 58% women | ADL index | ||||
| Mean age: 75.4 years (SD: 7.2) | |||||
| 100% Asian | |||||
| Depression as determinant, frailty as outcome | |||||
| Prince | 1997 | United Kingdom | OARS impairment scale | SHORT-CARE | Depression was positively associated with functional impairment, disability, and physical handicap. |
| n = 654 | |||||
| Age range: 65–98 years | SHORT-CARE | ||||
| 61% women | London Handicap Scale | ||||
| Racial composition unknown | Modified Katz scale | ||||
| Blyth | 2008 | Australia | Cardiovascular Health Study Frailty Index |
GDS | Depression was significantly associated with pain. The association between pain and frailty was significantly attenuated after adjusting for depression. |
| n = 1705 | |||||
| 100% men | |||||
| Mean age: 76.9 years (SD: 5.5) | |||||
| Racial composition unknown | |||||
| Deshpande | 2008 | Italy | SAFE | CES-D | Fear of falling was positively associated with depressive symptoms, physical weakness and slowness, and reduced activities. Depression modified the relationship between fear of falling and activity restriction. |
| n = 848 | |||||
| 55% women | FICSIT-4 | ||||
| Mean age: 75.9 years (SD: 6.4) | Repeated chair stand | ||||
| Racial composition unknown | Dynamometer | ||||
| Hajjar | 2009 | USA | Gait speed | CES-D | The confluence of depressive symptoms, slowness, and poor executive function describe a common phenotype that is associated with functional decline. |
| n = 580 | |||||
| 64% women | Trail Making Test Part B | ||||
| Mean age: 77.8 years (SD: 0.2) | Hopkins Verbal Learning Test | ||||
| 80% White, 14% Black | |||||
| Chang | 2010 | USA | Cardiovascular Health Study Frailty Index |
GDS | Depressive symptoms were significantly associated with frailty status. |
| n = 620 | |||||
| 100% women | |||||
| Age range: 70–79 years | |||||
| 80% White; 20% Black | |||||
| Chen | 2010 | Taiwan | Cardiovascular Health Study Frailty Index |
CES-D | Depressive symptoms were significantly associated with frailty status. |
| n = 2238 | |||||
| 49% women | |||||
| Age range: 65–103 years | |||||
| 100% Asian | |||||
ADLs, activities of daily living (e.g., hygiene, dressing, eating, toileting, basic mobility); IADLs, instrumental activities of daily living (e.g., keeping appointments, using the telephone, traveling, preparing meals, shopping, housework, managing medications, managing finances); GARS, Groningen Activity Restriction Scale; OARS, Older Americans Resources and Services; SAFE, Survey of Activities and Fear of Falling in the Elderly; FICSIT, Frailty and Injuries Cooperative Studies of Intervention Techniques; CES-D, Centers for Epidemiologic Studies—Depression Scale; GDS, Geriatric Depression Scale; SHORT-CARE, Comprehensive Assessment and Referral Evaluation—Short Form.