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

Abstract

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.