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Background The co-occurrence of physical frailty and depressive symptoms is highly prevalent in late life. However, their causal direction remains unclear. This study examined whether frailty and its components (slowness, weakness, exhaustion, low activity, and weight loss) predict the onset of depressive symptoms among older Japanese women. Methods In a two-year cohort study conducted in a metropolitan area of Tokyo, we collected baseline data in October 2017 and follow-up data in September 2019. Participants were community-dwelling older Japanese women, aged 65 to 80 years without any neurological diseases or depressive symptoms. Logistic regression analyses were applied to estimate odds ratios (OR) of the onset of depressive symptoms (15-item Geriatric Depression Scale [GDS] score ≥ 6) across the baseline frailty status or its components classified by the Japanese version of Cardiovascular Health Study criteria. Results Of the 477 women analysed (275 robust and 202 prefrail/frail). 6 (2.2%) robust and 16 (7.9%) prefrail or frail women developed depressive symptoms. After being adjusted for various covariates including baseline GDS score, the OR of the depressive symptom onset was 3.04 (95% confidence interval [CI]: 0.99, 10.47) in the prefrail or frail women. Among the five frailty components, slowness (OR: 7.55, 95%CI: 1.11, 48.98) and exhaustion (OR: 5.00, 95%CI: 1.60, 16.13) were independently associated with the onset of depressive symptoms. Conclusions Physical frailty status, particularly slowness and exhaustion, predict future depressive symptoms in older women. Key messages Early detection and intervention targeting physical frailty may help prevent depressive symptoms in later life.

940Physical frailty and the onset of depressive symptom in older Japanese women