Spousal Associations Between Frailty and Depressive Symptoms: Longitudinal Findings from the Cardiovascular Health Study

J Am Geriatr Soc. 2016 Apr;64(4):824-30. doi: 10.1111/jgs.14023.


Objectives: To determine whether older adult spouses' frailty states and depressive symptoms are interrelated over time.

Design: Longitudinal, dyadic path analysis using the Actor-Partner Interdependence Model.

Setting: Data were from baseline (1989-90), Wave 3 (1992-93), and Wave 7 (1996-97), all waves in which frailty and depressive symptoms were measured, of the Cardiovascular Health Study (CHS), a multisite, longitudinal, observational study of risk factors for cardiovascular disease in adults aged 65 and older.

Participants: Spouses in 1,260 community-dwelling married couples.

Measurements: Frailty was measured using the CHS criteria, categorized as nonfrail, prefrail, or frail. Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale.

Results: Within individuals (actor effects), greater frailty predicted greater subsequent depressive symptoms, and greater depressive symptoms predicted greater subsequent frailty. Between spouses (partner effects), an individual's greater frailty predicted the spouse's greater frailty, and an individual's greater depressive symptoms predicted the spouse's greater depressive symptoms.

Conclusion: Frailty and depressive symptoms are interrelated in older adult spouses. For older couples, interventions to prevent or treat frailty and depression that focus on couples may be more effective than those that focus on individuals.

Keywords: depression; dyadic analysis; frailty.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / epidemiology
  • Depression / epidemiology*
  • Female
  • Frail Elderly*
  • Humans
  • Longitudinal Studies
  • Male
  • Risk Factors
  • Spouses*
  • United States / epidemiology