Associação entre sintomas depressivos e a coexistência de fragilidade e vulnerabilidade na pessoa idosa no estado de Alagoas

Abstract

The aim of this study was to test the association between depressive symptoms and coexistence of fragility and vulnerability in elderly people living in the community in the State of Alagoas. This is a cross-sectional population-based study, an integral part of the 1st Alagoas Diagnosis of Health, Nutrition and Quality of Life of the Elderly, carried out between April 2022 and January 2024 through home visits, using a previously established printed form. The sample included 992 participants aged 60 years or older living in 11 municipalities of the state. Depressive symptoms were assessed using the Geriatric Depression Scale, while frailty was classified by Fried's criteria and vulnerability by the VES-13 instrument. The raw data analysis revealed a significant association between depressive symptoms, frailty (OR: 3.29; p<0.001) and vulnerability (OR: 1.32; p = 0.035) in the elderly population. Furthermore, when this phenotype coexists with vulnerability, the chances of the elderly person presenting depressive symptoms increase almost fourfold (OR: 3.63; p<0.001). However, in the multivariate logistic regression guided by Directed Acyclic Graph, the results showed that the coexistence of frailty and vulnerability significantly increased the chance of depressive symptoms (OR = 3.08; p < 0.001). Isolated frailty maintained an association with depressive symptoms (OR = 2.35; p < 0.001), while isolated vulnerability lost statistical significance after adjustment for confounding factors (p = 0.489). The coexistence of the frailty phenotype and the vulnerability condition in the same elderly person increases the chances of developing depressive symptoms when compared to the isolated existence of one of the two exposure conditions (frailty or vulnerability). It is noteworthy that when considering only the existence of vulnerability adjusted for confounding factors (regardless of frailty), this condition was not associated with depression.