The associations of depressive symptoms with cognitive and physical functions and frailty in elderly outpatients

Abstract

Objective To explore the associations of depressive symptoms with functional status and frailty in elderly outpatients. Methods A total of 297 geriatric outpatients(aged 65 years and over)from Zhejiang Hospital were recruited in the cross-sectional study from January 2014 to December 2015.We gathered general information, and evaluated depressive symptoms by Geriatric Depression Scale-15(GDS-15), cognitive function by mini-mental state examination(MMSE), frailty by clinical frailty scale(CFS), activities of daily living(ADL)by Barthel index, instrumental activities of daily living(IADL), balance, POMA and gait by Tinetti-performance oriented mobility assessment(Tinetti-POMA), grip strength and 4m gait speed by 4-meter walk gait speed test.According to the GDS-15 scores, 297 geriatric outpatients were divided into a depression symptom group(n=35, GDS-15≥6)and a non-depressive symptom group(n=262, GDS-15<6). The frailty and functional status were compared between two groups by SPSS 23.0. Results As compared with non-depressive symptoms, the depressive symptoms group had higher clinical frailty scale(CFS), lower body mass index(BMI), lower cognitive function and poorer grip strength and balance(all P<0.05). There were significantly negative correlations of Geriatric Depression Scale-15(GDS-15)with ADL, IADL, gait, balance, POMA and grip strength(r=-0.165、-0.154、-0.216、-0.291、-0.305、-0.314, All P<0.05), while there were significantly positive correlations with CFS score, gait speed(r=0.256、0.198, both P<0.05). The more severe the frailty was, the higher the risk of depressive symptoms was(OR=3.650, 95% CI 1.611-8.271). Conclusions The cognitive and physical functions in the elderly with depression symptoms are poorer as compared with the elderly without depression symptoms.Elderly outpatients with more severe frailty have a higher risk for depressive symptoms. Key words: Depression; Activities of daily living; Frailty; Cognitive