Associations of Apathy and Depressive Symptoms With Frailty Domains in Individuals Aged 75 Years Old: A...

Preventing and mitigating frailty across physical, cognitive, social, and oral domains is vital for extending healthy life expectancy in older adults. Although apathy and depressive symptoms are reportedly associated with frailty domains, their domain-specific relationships remain unclear. This study aimed to compare the associations of apathy and depressive symptoms with frailty domains in older adults.

This cross-sectional study included 465 community-dwelling adults aged ≥ 75 years (median age, 78 years; interquartile range, 76.0-82.0; 49.7% women) from the 2024 Shimane CoHRE Study. Apathy and depressive symptoms were defined as scores of ≥ 16 on the Japanese version of the Starkstein Apathy Scale and ≥ 40 on the Self-rating Depression Scale, respectively. Frailty domains across physical, cognitive, social, and oral domains were assessed using the Questionnaire for Medical Checkup of the Old-Old. Logistic regression analyses adjusted for age, sex, and body mass index.

The prevalence of apathy, depressive symptoms, and their coexistence was 30.8%, 29.9%, and 14.6%, respectively. Both apathy and depressive symptoms were significantly associated with a higher prevalence of physical frailty (lack of exercise), cognitive frailty (memory impairment), and social frailty (lack of interaction with others). Their coexistence was additionally associated with oral, physical, cognitive, and social frailty.

Apathy and depressive symptoms share some frailty domains but also exhibit domain-specific associations. Their coexistence may be associated with multidimensional frailty. These findings highlight the importance of assessing emotional function and tailoring frailty prevention to individual emotional profiles.