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The Relationship Between Depression and Frailty in Community‐Dwelling Older People: A Systematic Review and Meta‐Analysis of 84,351 Older Adults
Author(s) -
Chu Wen,
Chang ShuFang,
Ho HsuYu,
Lin HsiangChun
Publication year - 2019
Publication title -
journal of nursing scholarship
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.009
H-Index - 80
eISSN - 1547-5069
pISSN - 1527-6546
DOI - 10.1111/jnu.12501
Subject(s) - depression (economics) , meta analysis , medicine , cochrane library , gerontology , medline , geriatric depression scale , odds ratio , systematic review , demography , depressive symptoms , psychiatry , cognition , sociology , political science , law , economics , macroeconomics
Abstract Objectives In this study we investigated the correlation between depression and frailty in older adults. Additionally, correlations among study designs (prospective vs. cross‐sectional), regions, depression indices, frailty indices, covariance corrections, and sexes were explored to support the analysis. Methods A systematic literature review and meta‐analysis were conducted. A total of 84,351 older adults, all 65 years of age or older, were analyzed. Both authors independently extracted and examined retrieved articles. Searched keywords included “depression” or “depressive”; “frailty” or “frail”; and “older people,” “elderly,” “geriatric,” or “senior.” Articles published between January 2000 and December 2016 were searched. A literature quality assessment was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Systematic literature searches were conducted on the Embase, PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library databases, and collected studies were analyzed using a random effects model. Results Fourteen studies on people 65 years of age or older were collected, and a correlation analysis was conducted for depression and frailty. According to the meta‐analysis, the risk for frailty due to depression was nonsignificant among the subgroups for study design ( p for heterogeneity = .149), region ( p = .429), depression criteria ( p = .934), covariate adjustment ( p = .702), and frailty criteria ( p = .661). Notably, the risk for frailty due to depression was significantly higher in men than in women (pooled odds ratios for men and women: 4.76 and 2.25, respectively; Qbetween χ 2 = 9.93, p = .002). Conclusion Older adults with depression are more prone to frailty than are those without depression. Regardless of study design, region, depression index, frailty index, and covariance corrections, no significant differences were observed in the results of studies on depression and frailty in older adults. The only factor that had a significant influence was sex; older men with depression were at a higher risk for frailty than were older women with depression. Clinical Relevance Depression and frailty are pertinent health concerns related to geriatric syndromes. Because older adults with depression have a high risk for frailty, nursing personnel should use a depression index as early as possible to screen for depression and further reduce the occurrence of frailty in older adults. Furthermore, based on the aforementioned differences between the sexes, special attention should be paid to older men with depression to reduce their risk for frailty.