Social frailty and longitudinal risk of depressive symptoms in a Chinese population: the Rugao Longevity and Aging Study

Aim To explore the cross‐sectional and longitudinal associations between social frailty (SF) and incident depressive symptoms in a Chinese population. Methods SF was measured with 6 questions (6 points maximum; 0–1 = non‐SF, 2–3 = pre‐SF, 4–6 = SF). Depressive symptoms were defined as a score of ≥6 on the Geriatric Depression Scale. Compared to baseline, participants with a ≥2‐point increase in the Geriatric Depression Scale score were considered to have worsening depressive symptoms. Results At baseline, among 1764 participants, 9.9% ( n  = 175) had depressive symptoms, 3.6% ( n  = 61) were SF, and 38.2% ( n  = 650) were pre‐SF. The percentage of depressive symptoms increased with SF status from 5.1% (non‐SF) to 12.9% (pre‐SF), to 41.0% (SF). In cross‐sectional analysis, after adjustments for multiple covariates, depressive symptoms were significantly associated with both pre‐SF (odds ratio (OR) = 2.94, 95% confidence interval (CI) 2.01–4.32) and SF (OR = 16.70, 95% CI 8.80–31.71). During the 3‐year follow‐up period, 10.0% ( n  = 117) of the participants developed depressive symptoms. In longitudinal analyses, after multiple adjustments, SF and pre‐SF were associated with a 2.31‐fold (95% CI 1.10–4.88) and 1.58‐fold (95% CI 1.05–2.38) increased risk of incidence of depressive symptoms, respectively. Among participants without depressive symptoms at baseline, 23.2% had worsening depressive symptoms, and SF was associated with increased risk of worsening depressive symptoms (OR = 2.07, 95% CI 1.18–3.65). Conclusions Our findings suggested that SF may be a predictor of depression among Chinese community‐dwelling older adults. In addition, in elders with no depressive symptoms at baseline, those with SF had greater odds of worsening depressive symptoms 3 years later.