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Assessment of incident frailty hazard associated with depressive symptoms in a Taiwanese longitudinal study

Published online by Cambridge University Press:  19 July 2021

Che-Chia Chang
Affiliation:
Department of Psychiatry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Chi-Shin Wu
Affiliation:
Department of Psychiatry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Han-Yun Tseng
Affiliation:
Department of Human Development, Cornell University, Ithaca, NY, USA Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
Chun-Yi Lee
Affiliation:
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
I-Chien Wu
Affiliation:
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
Chih-Cheng Hsu
Affiliation:
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
Hsing-Yi Chang
Affiliation:
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
Yen-Feng Chiu*
Affiliation:
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
Chao A. Hsiung
Affiliation:
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
*
Correspondence should be addressed to: Yen-Feng Chiu, Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Rd., Zhunan, Miaoli County 35053, Taiwan. Phone: +886 37 206 166; Fax: +886 37 586 467. Email: yfchiu@nhri.edu.tw.

Abstract

Objectives:

To estimate the risks of depressive symptoms for developing frailty, accounting for baseline robust or pre-frailty status.

Design:

An incident cohort study design.

Setting:

Community dwellers aged 55 years and above from urban and rural areas in seven regions in Taiwan.

Participants:

A total of 2,717 participants from the Healthy Aging Longitudinal Study in Taiwan (HALST) were included. Subjects with frailty at baseline were excluded. The average follow-up period was 5.9 years.

Measurements:

Depressive symptoms were measured by the 20-item Center for Epidemiological Studies Depression (CES-D) Scale. Frailty was assessed using the Fried frailty measurement. Participants were stratified by baseline robust or pre-frailty status to reduce the confounding effects of the shared criteria between depressive symptoms and frailty. Overall and stratified survival analyses were conducted to assess risks of developing frailty as a result of baseline depressive symptoms.

Results:

One hundred individuals (3.7%) had depressive symptoms at baseline. Twenty-seven individuals (27.0%) with depressive symptoms developed frailty, whereas only 305 out of the 2,617 participants (11.7%) without depressive symptoms developed frailty during the follow-up period. After adjusting for covariates, depressive symptoms were associated with a 2.6-fold (95% CI 1.6, 4.2) increased hazard of incident frailty. The patterns of increased hazard were also observed when further stratified by baseline robust or pre-frailty status.

Conclusions:

Depressive symptoms increased the risk of developing frailty among the older Asian population. The impact of late-life depressive symptoms on physical health was notable. These findings also replicated results from Western populations. Future policies on geriatric public health need to focus more on treatment and intervention against geriatric depressive symptoms to prevent incident frailty among older population.

Type
Original Research Article
Copyright
© International Psychogeriatric Association 2021

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Footnotes

These two authors contributed equally to this work.

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