background Although criteria for frailty and depression partially overlap and both syndromes are associated with adverse health outcomes, there is a lack of research into their (reciprocal) relationship. Due to symptom overlap, frail elderly may be misdiagnosed as depressed. If true, the classical correlates of depression would be less prevalent in this group.
aim To compare the prevalence of frailty in depressed older adults with the prevalence of frailty in non-depressed older adults, and to compare classical correlates of depression between depressed elderly with and those without frailty.
method Cross-sectional observational study embedded within nesdo. Depression was assessed with the Composite International Diagnostic Interview. Severity of depression was measured with Inventory of Depressive Symptomatology (ids). Frailty was defined according to the criteria of Fried and colleagues. In this definition three or more of the following criteria must be present: weight loss, slowness, poor endurance and energy, weakness and low physical activity level.
results The prevalence of frailty was significantly higher in the depressed group than in the non-depressed group (21.3% versus 1.8%). Frail depressed elderly were more severely depressed compared to non-frail depressed elderly. After controlling for the severity of depressive symptoms (and other covariates like age, gender, living circumstances, educational level, and somatic comorbidity), there was no difference in correlates of depression between frail depressed elderly and non-frail depressed elderly, except for the frequency of comorbid somatic diseases. Post hoc analyses with both unidimensional definitions of frailty (weakness, slowness) and different symptom profiles of depression (ids factor analysis, adjusted ids-score without somatic items) confirmed these results
conclusion The prevalence of frailty among depressed older adults is high, and cannot be explained fully by symptom overlap. This argues for the need of frailty screening, as well as multidisciplinary care.