Changes in frailty and depressive symptoms among middle-aged and elderly Chinese: a nationwide cohort study

Background and Aims: The elderly population bears a severe burden of disease due to frailty and depressive symptoms, however, the results of association between the two in the elderly Chinese population have been conflicting. Therefore, this study aimed to investigate the developmental trajectories and interactions of frailty and depressive symptoms in the Chinese middle-aged and elderly population. Methods The study used three waves of data from 2011, 2013, and 2015 in the China Health and Retirement Longitudinal Study (CHARLS) database, focused on middle-aged and elderly people ≥ 45 years of age, and analyzed using latent growth models and cross-lagged models. Results According to the parallel latent growth model's findings, the initial level of depressive symptoms had a significant positive predictive effect on the initial level of frailty and a significant negative predictive effect on the rate of change in frailty. A substantial positive predictive relationship existed between the rate of change in depressive symptoms and the rate of change in response to frailty. The overall sample population, the middle-aged population, and the elderly population all showed evidence of a bidirectional causal connection between frailty and depressive symptoms as a result of cross-lagged analyses. Conclusions This study recommended advancing the age of concern for frailty and depressive symptoms to middle-aged adults. In the middle-aged and elderly Chinese population, the higher the initial level of frailty and the faster the rate of change, the higher the initial level of depressive symptoms and the faster the rate of change.