The Reciprocal Relationship between Frailty and Depressive Symptoms among Older Adults in Rural China: A Cross-Lag Analysis.

Xuehui Wang,Kaijun Shen

doi:10.3390/healthcare9050593

Abstract

(1) Objective: This study aimed to investigate the reciprocal relationship between frailty and depressive symptoms using longitudinal data among older adults in China. (2) Methods: Data derived from 2014 and 2017 waves of a longitudinal study of 1367 older adults aged 70–84 years, living in rural areas of Jiangsu Province, China. Cross-lagged panel model and a multiple group model were used to examine the temporal effect of frailty on depressive symptoms and vice versa. (3) Results: Frailty was associated with subsequent increase in depressive symptoms, such that participants with higher levels of frailty increase the risks of depressive symptoms (b = 0.090, p < 0.01). Depressive symptoms were significant predictors of increased frailty (b = −0.262, p <0.001). However, older men and older women had no significant differences in the reciprocal relationship between frailty and depressive symptoms. (4) Conclusions: In conclusion, we find a significant bi-directional relationship between frailty and depressive symptoms. This finding confirms the dyadic model of frailty and depression. Implications for interventions and policy to help frail and depressive older adults are discussed.

Highlights

Frailty and depressive symptoms are two common health issues among older adults.According to previous studies, the prevalence of frailty varies from 4.9% to 27.3% in community-dwelling adults aged 65 and over [1], the prevalence of depressive symptoms in community samples of adults aged 65 and older ranges from 1% to 5% in most large-scale epidemiological investigations [2]
Among the cross-lagged correlations of frailty and depressive symptoms, the results showed that 2014 frailty was a significant predictor of 2017 depressive symptoms (β = 0.090, p < 0.01), and 2014 depression was a significant predictor of 2017 frailty (β = 0.262, p < 0.001)
Consistent with previous studies, we found that frailty predicts the level of depressive symptom which means that those with a higher degree of frailty showed a higher level of depressive symptoms in the following wave, which supported Hypothesis 1

Summary

Introduction

The prevalence of frailty varies from 4.9% to 27.3% in community-dwelling adults aged 65 and over [1], the prevalence of depressive symptoms in community samples of adults aged 65 and older ranges from 1% to 5% in most large-scale epidemiological investigations [2]. One is the overlap in some areas of diagnostic criteria, such as unintentional weight loss, making it difficult to distinguish between individuals Another factor is that frailty and depression have some common etiology [19]

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Methods

Discussion

Conclusion