Sarcopenia and Depression in Older Adults: 2-Year Findings From the Korean Frailty and Aging Cohort Study

To investigate sex-specific associations of sarcopenia and its diagnostic components with the 2-year incidence of depression in community-dwelling older adults.

Prospective cohort study with a 2-year follow-up.

Data were drawn from the nationwide Korean Frailty and Aging Cohort Study. A total of 1442 community-dwelling Korean adults aged 70-84 years without depression at baseline were included.

Sarcopenia was defined according to the 2019 Asian Working Group for Sarcopenia criteria. Depression risk was assessed using the Korean version of the 15-item Short-Form Geriatric Depression Scale, with incident depression defined as a score ≥8. Sex-stratified logistic regression analyses were performed using directed acyclic graph-informed lean models, with sex-specific adjustments for age, cognitive function, physical activity, and socioeconomic factors.

Over the 2-year follow-up, 44 men (5.7%) and 60 women (9.0%) developed depression. Sarcopenia was independently associated with incident depression in women [odds ratio (OR), 2.27; 95% confidence interval (CI), 1.21-4.24] but not in men. Among the diagnostic components, impaired physical performance was associated with incident depression in women (OR, 2.04; 95% CI, 1.13-3.69), with prolonged 5-times sit-to-stand (5-STS) performance showing the strongest association (OR, 1.80; 95% CI, 1.03-3.13). In men, overall sarcopenia was not significant; however, slow gait speed was associated with incident depression (OR, 2.05; 95% CI, 1.03-4.06). Additional factors associated with incident depression included low physical activity and higher comorbidity burden in men, and low economic status and poorer cognitive function in women.

Sarcopenia-particularly impaired physical performance-was associated with incident depression in older adults, with clinically meaningful sex-specific patterns. Incorporating simple physical performance measures into routine geriatric assessments may help identify individuals at high risk of late-life depression.