Although frailty is a well-established risk factor for adverse health outcomes in later life, little is known about the role of physical frailty on the development of incident major depressive disorder (MDD). The purpose of this study was to determine whether frailty is an important and independent predictor of incident major depressive disorder (MDD) in elderly people without probable depression at baseline. Of the 3671 older individuals from the population-based Irish Longitudinal Study on Ageing, we classified participants as non-frail (0), pre-frail (1-2), and frail (3-5) at baseline according to the five criteria of the physical frailty phenotype. The World Health Organization Composite International Diagnostic Interview Short-Form was used to assess whether respondents fulfilled the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for MDD over a 4-year follow-up. After adjusting for demographic factors, living arrangements, health behaviors, common chronic diseases including hypertension, diabetes, cancer, lung disease, heart problems, and stroke, those classified as pre-frail (HR = 1.40, 95%CI = 1.14-1.73) and frail (HR = 2.20, 95%CI = 1.23-3.92) presented a higher risk to develop incident MDD over the 4-year follow-up compared to non-frail participants. Shrinking and exhaustion, as physical frailty components, were individually predictive of onset of MDD. The present study supports a significant role of physical frailty as a predictor of incident MDD in older adults. It is necessary to identify groups with a high vulnerability for MDD according to easily identifiable frailty criteria, and to delay or prevent at least in part, some of the negative health outcomes related to this disorder.

中文翻译：

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身体虚弱和重度抑郁症的风险：爱尔兰纵向老龄化研究。

尽管身体虚弱是以后生活中不利健康后果的公认危险因素，但对于身体虚弱在事件性重度抑郁症（MDD）发生中的作用知之甚少。这项研究的目的是确定脆弱性是否是基线时可能没有抑郁症的老年人发生重大抑郁症（MDD）的重要且独立的指标。在基于人口的爱尔兰纵向老龄化研究中的3671名老年人中，我们根据五项标准将参与者分为基线：脆弱（0），脆弱（1-2）和脆弱（3-5）。身体虚弱的表型。使用世界卫生组织综合性国际诊断面试简短表，评估受访者在4年的随访中是否达到了《精神障碍诊断和统计手册-IV（MDM-IV）》的MDD标准。在调整了人口统计学因素，生活安排，健康行为，常见的慢性病（包括高血压，糖尿病，癌症，肺病，心脏病和中风）后，将其归类为体弱者（HR = 1.40，95％CI = 1.14-1.73）与不体弱的参与者相比，在4年的随访中，体弱的人（HR = 2.20，95％CI = 1.23-3.92）发生MDD的风险更高。收缩和疲惫是身体虚弱的组成部分，可单独预测MDD的发作。本研究支持身体虚弱作为老年人中发生MDD的预测因素的重要作用。有必要根据易于识别的脆弱标准确定MDD易感性高的人群，并至少部分地延迟或预防与该疾病有关的某些负面健康后果。