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Background <p>Depression is linked to a high risk of mortality from any causes in older adults. However, the role of frailty or quality of life (QOL) as a mediator in the relationship of mortality and depression in older populations has yet to be determined. Mediating variable (frailty or QOL) plays a prominent role in exploring the association between depression and all-cause mortality. The objective of this study is to examine the association between depression and all-cause mortality among community-dwelling older adults and determine the extent to which frailty or QOL acts as a mediator in the association of depression with mortality.</p> Methods <p>Data were obtained from a prospective study of the Taichung Community Health Study for Elders (TCHS-E) that analyzed 988 older adults (≥ 65 years) who were recruited in 2009 and study period lasted until 2021. Depression, frailty, and QOL were measured using the Geriatric Depression Scale (GDS), Fried’s five criteria, and the Short Form 36-item health survey (SF-36), respectively. Cox models were employed to evaluate the associations of depression with all-cause mortality. Mediation models were conducted to estimate the proportional impact of frailty and QOL for the relationship of depression to mortality.</p> Results <p>After 12 years of median follow-up, 357 older persons died. After multivariable adjustment, GDS, frailty components, and four SF-36 domains of physical functioning (PF), general perception of health (GH), social functioning (SF), and physical component summary (PCS) were associated with a 12-year mortality from any causes (hazard ratio [HR]: 1.06, 95% confidence interval [CI]: 1.01–1.11; 1.52, 1.36–1.70; 0.99, 0.98–0.99, 0.99; 0.98–0.99, 0.99; 0.99–1.00; 0.97, 0.96–0.98, respectively). The frailty components, PF, SF, and PCS were significant mediators, mediating 49.47%, 52.02%, 42.66%, and 38.13% of the effect of GDS on mortality.</p> Conclusions <p>Frailty, physical function, and social function significantly mediated the relationship between depression and mortality.</p>

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Relationship of depression and mortality in community-residing elderly individuals: mediating role of frailty and quality of life

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月2日

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  • Cheng-Chieh Lin,
  • Chia-Ing Li,
  • Chiu-Shong Liu,
  • Chih-Hsueh Lin,
  • Shing-Yu Yang,
  • Tsai-Chung Li

摘要

Background

Depression is linked to a high risk of mortality from any causes in older adults. However, the role of frailty or quality of life (QOL) as a mediator in the relationship of mortality and depression in older populations has yet to be determined. Mediating variable (frailty or QOL) plays a prominent role in exploring the association between depression and all-cause mortality. The objective of this study is to examine the association between depression and all-cause mortality among community-dwelling older adults and determine the extent to which frailty or QOL acts as a mediator in the association of depression with mortality.

Methods

Data were obtained from a prospective study of the Taichung Community Health Study for Elders (TCHS-E) that analyzed 988 older adults (≥ 65 years) who were recruited in 2009 and study period lasted until 2021. Depression, frailty, and QOL were measured using the Geriatric Depression Scale (GDS), Fried’s five criteria, and the Short Form 36-item health survey (SF-36), respectively. Cox models were employed to evaluate the associations of depression with all-cause mortality. Mediation models were conducted to estimate the proportional impact of frailty and QOL for the relationship of depression to mortality.

Results

After 12 years of median follow-up, 357 older persons died. After multivariable adjustment, GDS, frailty components, and four SF-36 domains of physical functioning (PF), general perception of health (GH), social functioning (SF), and physical component summary (PCS) were associated with a 12-year mortality from any causes (hazard ratio [HR]: 1.06, 95% confidence interval [CI]: 1.01–1.11; 1.52, 1.36–1.70; 0.99, 0.98–0.99, 0.99; 0.98–0.99, 0.99; 0.99–1.00; 0.97, 0.96–0.98, respectively). The frailty components, PF, SF, and PCS were significant mediators, mediating 49.47%, 52.02%, 42.66%, and 38.13% of the effect of GDS on mortality.

Conclusions

Frailty, physical function, and social function significantly mediated the relationship between depression and mortality.