Overlap of Frailty and Depression and Its Association With Cardiovascular Disease: A Population-Based Study

Background: Depression and frailty are prevalent geriatric syndromes. Their co-occurrence may define a phenotype of heightened cardiovascular disease (CVD). In Latin America the joint association of these syndromes with CVD has not been previously characterised. Objective: To evaluate the association between the overlap of depression and frailty and the prevalence of CVD in older adults. Methods: A cross-sectional analysis was conducted using data from the 2015 SABE Colombia study. Adults aged ≥60 years with complete information on depression, frailty, and history of acute myocardial infarction or stroke defined as CVD were included. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were estimated using bivariate and multivariate log-binomial regression models. Results: 18,973 participants were analysed (mean age 69.3 ± 7.1 years; 56% women). The prevalence of depression, frailty, and CVD was 57.3%, 3.5%, and 15.4%, respectively. In bivariate analyses, depression (PR 1.83, 95% CI 1.51-2.23), prefrailty (PR 1.61, 95% CI 1.50-1.73), and frailty (PR 2.91, 95% CI 2.57-3.28) were associated with CVD. In multivariate model, the overlap of depression and frailty demonstrated the strongest association with CVD (PR 4.86; 95% CI 3.37-7.01), exceeding that of depression with prefrailty and each condition individually. This association persisted after adjustment for traditional cardiovascular risk factors (PR 2.05, 95% CI 1.05-3.97). Conclusion: In older adults, the overlap of depression and frailty remained associated with a higher prevalence of CVD after adjustment for traditional cardiovascular risk factors. Although the association was attenuated after adjustment, the coexistence of both conditions remained associated with increased cardiovascular burden.