Abstract
BACKGROUND: Frailty and depression are highly prevalent in older adults. However, the complex association of their interlinked factors, including lifestyle behaviors, remains unexplored in population-based epidemiological studies. AIMS: This study aimed to evaluate the relationship between frailty and depression and to determine associated modifiable lifestyle risk factors for depression among older adults in the UK Biobank (UKB). METHODS: Data were obtained from 69,178 older adults (aged ≥ 65 yrs) in the baseline survey of the UKB. Frailty status was measured using the frailty phenotype criteria (range: 0-5). Participants were classified into frail (≥ 3), pre-frail (1-2), and non-frail (0) groups. The outcome of depression was defined by participants who had sought medical attention for nerves, anxiety, tension, or depression. Lifestyle behaviors included the self-reported time spent in moderate-to-vigorous physical activity (MVPA), screen-based sedentary behavior, and sleep. The association of interest is examined using multivariable logistic regression models. RESULTS: 29% of participants had depression, of which 7% and 45% were frail and pre-frail, respectively. Significant correlations are observed between frailty and lifestyle behaviors (p's < 0.05). Frailty is significantly associated with increased odds of having depression (Frail: aOR = 1.87, 95% CI = 1.72, 2.04); Pre-frail: aOR = 1.22, 95% CI = 1.18, 1.27), and sleep (7-8 h/d) is associated with lower odds of having depression (aOR = 0.81, 95% CI = 0.78, 0.84). CONCLUSION: Frail and pre-frail older adults have a higher likelihood of experiencing depression than their non-frail counterparts. Meeting the recommended sleep duration (7-8 h/d) can be used as a modifiable behavioral strategy to manage or prevent depression. Further longitudinal studies are warranted to examine the time sequence in this relationship.