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Association between frailty and depression in older adults with coronary heart disease: a systematic review and

Yuan Chen1, Zhaoxia Zhang1, Yuanling Tang2

  • 1Department of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.

Frontiers in Public Health
|April 29, 2026
PubMed

Insights

Frailty and depression are significantly linked in older adults with coronary heart disease (CHD). This meta-analysis found a 2.45 times higher odds of depression in frail individuals with CHD, highlighting the need for integrated care.

Area of Science:

  • Gerontology
  • Cardiology
  • Psychiatry

Background:

  • Frailty and depression are common in older patients with coronary heart disease (CHD).
  • Both conditions are associated with poor health outcomes.
  • The precise relationship between frailty and depression in CHD patients requires quantification.

Purpose of the Study:

  • To systematically quantify the association between frailty and depression in adults with CHD.
  • To synthesize evidence from observational studies on this comorbidity.
  • To identify potential differences in association based on study design.

Main Methods:

  • A systematic literature search was conducted across major databases (PubMed, Embase, Web of Science) up to April 2025.
  • Observational studies (cohort and cross-sectional) examining frailty and depression in CHD patients were included.
  • A random-effects model was used for meta-analysis, calculating pooled odds ratios (ORs) and 95% confidence intervals (CIs).
  • Study quality was assessed using the Newcastle-Ottawa Scale and AHRQ checklist.

Main Results:

  • Six studies involving 2,628 older adults with CHD were included.
  • A significant positive association was found between frailty and depression (pooled OR = 2.45; 95% CI: 1.22-4.92).
  • Substantial heterogeneity was observed (I² = 90%).
  • The association was stronger in cohort studies (OR = 3.92) compared to cross-sectional studies (OR = 1.91).

Conclusions:

  • Frailty and depression are significantly associated in older adults with CHD.
  • Findings support the integration of frailty and depression screening in CHD care.
  • Further prospective studies are needed to establish causality due to high heterogeneity and limited cohort data.
Abstract

Keywords:
associationcoronary heart diseasedepressionfrailtymeta-analysis

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