Multitrajectories of Frailty and Depression With Cognitive Function: Findings From the Health and Retirement Longitudinal Study
Chengxiang Hu, Xiaoyue Sun, Zhirong Li, Yue He, Beibei Han, Zibo Wu, Siyu Liu, Lina Jin
Abstract
BACKGROUND: Little is known about the joint associations between trajectories of frailty and depression with cognitive function. This study aims to explore the multitrajectories of frailty and depression and their joint impact on cognition. METHODS: A total of 8600 participants from the Health and Retirement Study (HRS) (1996-2018) were analysed using a group-based trajectory model for 10-year multitrajectories. Participants were classified into five groups based on their trajectories. Multivariable linear mixed models and Cox proportional hazards models were utilized. RESULTS: Compared with Group 1 (stable robust and nondepressed), Groups 2 ('worsening prefrailty without depression,' β = -0.022 SD/year), 3 ('stable prefrailty with escalating depressive symptoms,' β = -0.016 SD/year), 4 ('increasing frailty alongside worsening depressive symptoms,' β = -0.034 SD/year) and 5 ('high and escalating frailty with persistent depression,' β = -0.055 SD/year) exhibited accelerated cognitive decline. Dementia risk was significantly higher in G2 (HR = 1.26, 95% CI: 1.08-1.48), G3 (HR = 1.54, 95% CI: 1.31-1.80), G4 (HR = 1.81, 95% CI: 1.54-2.14) and G5 (HR = 1.86, 95% CI: 1.48-2.33) compared with G1. CONCLUSIONS: Worsening frailty and depression accelerate cognitive decline and risk of dementia, underscoring the need to address both conditions to mitigate cognition.