Overlap of Frailty and Depression and Its Association With Cardiovascular Disease: A Population-Based Study

Abstract

Background Depression and frailty are prevalent geriatric syndromes. Their co-occurrence may define a phenotype of heightened cardiovascular disease (CVD). In Latin America the joint association of these syndromes with CVD has not been previously characterised. Objective To evaluate the association between the overlap of depression and frailty and the prevalence of CVD in older adults. Methods A cross-sectional analysis was conducted using data from the 2015 SABE Colombia study. Adults aged ≥60 years with complete information on depression, frailty, and history of acute myocardial infarction or stroke defined as CVD were included. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were estimated using bivariate and multivariate log-binomial regression models. Results 18,973 participants were analysed (mean age 69.3 ± 7.1 years; 56% women). The prevalence of depression, frailty, and CVD was 57.3%, 3.5%, and 15.4%, respectively. In bivariate analyses, depression (PR 1.83, 95% CI 1.51–2.23), prefrailty (PR 1.61, 95% CI 1.50–1.73), and frailty (PR 2.91, 95% CI 2.57–3.28) were associated with CVD. In multivariate model, the overlap of depression and frailty demonstrated the strongest association with CVD (PR 4.86; 95% CI 3.37–7.01), exceeding that of depression with prefrailty and each condition individually. This association persisted after adjustment for traditional cardiovascular risk factors (PR 2.05, 95% CI 1.05–3.97). Conclusion In older adults, the overlap of depression and frailty remained associated with a higher prevalence of CVD after adjustment for traditional cardiovascular risk factors. Although the association was attenuated after adjustment, the coexistence of both conditions remained associated with increased cardiovascular burden.