Prevalence of frailty and its association with depressive symptoms among older adults in Singapore

Objectives: The aims of the study were to (1) estimate the prevalence of frailty among community-dwelling older adults , and (2) investigate the independent association between level of frailty and depressive symptoms.

Methods: A total of 721 older adults (aged 60 and above ) were included in this study. Severity of frailty was determined using the Clinical Frailty Scale and further classified into four levels (CFS1-3: F1, CFS4: F2, CFS5: F3, and CFS6-7: F4). The depressive symptoms were assessed using the Patient Health Questionnaire-9. The prevalence of frailty by four levels was described and the association between level of frailty and depressive symptoms was assessed using multiple linear regression.

Results: The prevalence of frailty among the study population was 24.5% (F2: 14.4%, F3:3.7%, F4: 6.4%). There was no significant difference in level of frailty between male and female. With the increase in severity level of frailty, older adults reported substantially higher depressive symptom scores (p < .001), even after controlling for socio-demographics, number of non-mental chronic conditions, and number of medications taken regularly.

Conclusions: Level of frailty is independently associated with depressive symptoms among community-dwelling older population, which is not fully explained by symptom overlap, socio-demographic, and comorbidity covariates.