Skip to main content

Frailty and depression in centenarians

  • Oscar Ribeiro (a1), Natália Duarte (a2), Laetitia Teixeira (a3) and Constança Paúl (a4)

Physical frailty and depression are common comorbid conditions that have important impact on older adults. Few studies however have examined their co-occurrence in centenarians. This paper explores the relationship between the two conditions and the most characteristic depressive symptoms associated with the frailty syndrome.


Data come from two Portuguese Centenarian Studies. Frailty was measured using Fried's phenotype, which includes at least three clinical signs: exhaustion, weight loss, weakness, slowness, and low physical activity level; the Geriatric Depression Scale was used to assess depression. Descriptive comparison and binary logistic regression models were used for data analysis.


The final sample comprised 91 centenarians (mean age = 101.0, SD = 1.3; 85.7% female). From these, 5.5% were classified as robust, 42.9% as pre-frail, and 51.6% as frail. The prevalence of depression in the whole sample was 35.2% (51.1% in frail centenarians; 21.1% in pre-frail centenarians; 0% in robust centenarians). Frail centenarians presented higher risk of depression (OR = 3.92; 95% CI 1.48–10.4) when compared to pre-frail centenarians. Findings from the multivariable model (gender, living arrangements, education, cognition, subjective health, current illness, and functionality) revealed that only subjective health remained significant.


It seems that depression is a comorbid clinical independent condition that is frequent in frail and pre-frail centenarians.

Corresponding author
Correspondence should be addressed to: Oscar Ribeiro, Institute of Biomedical Sciences Abel Salazar, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal. Phone: +351220428161. Email:
Hide All
Apóstolo, J. (2011). Adaptation into European Portuguese of the Geriatric Depression Scale (GDS-15), Paper presented at the XI Conferência Iberoamericana de Educação em Enfermagem da ALADEF, Coimbra, Portugal.
Baldwin, R. C. (2010). Depression in Later Life. New York, NY: Oxford University Press.
Collard, R. M., Boter, H. and Schoevers, R. A. (2012). Prevalence of frailty in community-dwelling older persons: a systematic review. Journal of the American Geriatrics Society, 60, 14871492. doi: 10.1111/j.1532-5415.2012.04054.x.
Duarte, N., Teixeira, L., Ribeiro, O. and Paúl, C. (2014). Frailty phenotype criteria in centenarians: findings from the Oporto Centenarian Study. European Geriatric Medicine, 5, 371376, 2014.
Fillenbaum, G. G. (1988). Multidimensional Functional Assessment of Older Adults: The Duke Older Americans Resources and Services Procedures. Hilldale, NJ: Lawrence Erlbaum Associates, Publishers.
Folstein, M., Folstein, S. and McHugh, P. (1975). ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198. doi:10.1016/0022-3956(75)90026-6.
Fried, L. P. et al. (2001). Frailty in older adults: evidence for a phenotype. Journals of Gerontology Series A-Biological Sciences and Medical Sciences, 56, 146157. doi: 10.1093/gerona/56.3.M146.
Gobbens, R. J. J., van Assen, M. A. L. M., Luijkx, K. G., Wijnen-Sponselee, M. T. and Schols, J. M. (2010). The tilburg frailty indicator: psychometric properties. Journal of the American Medical Directors Association, 1, 344355. doi: 10.1016/j.jamda.2009.11.003.
Gonzalez-Pichardo, A. M. et al. (2013). Association between self-reported health status and frailty in community-dwelling elderly. The Journal of Frailty and Aging, 3, 104108. doi: 10.14283/jfa.2014.9.
Greenberg, S. A. (2007). How to try this: the geriatric depression scale: short form. The American Journal of Nursing, 10, 6069. doi: 10.1097/01.NAJ.0000292204.52313.f3.
Gu, D. and Feng, Q. (2015). Frailty still matters to health and survival in centenarians: the case of China. BMC Geriatrics, 15, 59. doi: 10.1186/s12877-015-0159-0.
Guerreiro, M., Silva, A., Botelho, M., Leitão, O., Castro-Caldas, A. and Garcia, C. (1994). Adaptação à população portuguesa da tradução do mini mental state examination [Adaptation to the Portuguese population of the Mini-Mental State Examination]. Revista Portuguesa De Neurologia, 1, 910.
Holtsberg, P. A., Poon, L. W., Noble, C. A. and Martin, P. (1995). Mini Mental State Exam status of community-dwelling cognitively intact centenarians. International Psychogeriatrics, 7, 417427. doi:10.1017/S104161029500216X.
Kwan, J. S. K., Lau, B. H. P. and Cheung, K. S. L. (2016). Toward a comphreensive model of frailty: an emerging concept from the Hong Kong Centenarian study. The Journal of Post-Acute and Long-Term Care Medicine, 16, 536. doi: 10.1016/j.jamda.2015.03.005.
Lau, B. H., Kwan, J. S. and Cheung, K. S. (2016a). Overlap of frailty, comorbidity, disability, and poor self-rated health in community-dwelling near-centenarians and centenarians. Journal of the American Geriatrics Society, 64 (4), 900901. doi: 10.1111/jgs.14063
Lau, B. H., Kwan, J. S., Cheung, K. S. and Martin, P. (2016b). Depression moderates the frailty-subjective health link among Chinese near centenarians and centenarians, The American Journal of Geriatric Psychiatry. doi: 10.1016/j.jagp.2016.05.014.
Lohman, M., Dumenci, L. and Mezuk, B. (2014). Sex differences in the construct overlap of frailty and depression: evidence from the Health and Retirement Study. Journal of the American Geriatrics Society, 62, 500505. doi: 10.1111/jgs.12689.
Lohman, M., Dumenci, L. and Mezuk, B. (2016). Depression and frailty in late life: evidence for a common vulnerability. Journal of Gerontology series B: Psychological Sciences and Social Sciences, 71, 630640. doi: 10.1093/geronb/gbu180.
Mezuk, B., Edwards, L., Lohman, M., Choi, M. and Lapane, K. (2012). Depression and frailty in later life: a systematic review. International Journal of Geriatric Psychiatry, 27, 879–92. doi: 10.1002/gps.2807.
Mhaoláin, A. M. N. et al. (2012). Frailty, depression and anxiety in later life. International Psychogeriatrics, 24, 12651274. doi: 10.1017/S1041610211002110.
Nascimento, P. P. P., Batistoni, S. S. T. and Neri, A. L. (2016). Frailty and depressive symptoms in older adults: data from the FIBRA study – UNICAMP. Psicologia: Reflexão e Crítica, 29.
Nybo, H., Gaist, D., Jeune, B. McGue, M, Vaupel, J. W. and Christensen, K. (2001). Functional status and self-rated health in 2,262 nonagenarians: the danish 1905 cohort survey. Journal of the American Geriatrics Society, 49, 601609. doi: 10.1046/j.1532-5415.2001.49121.x.
Reisberg, B., Ferris, S. H., de Leon, M. J. and Crook, T. (1982). The global deterioration scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 139, 11361139. doi: 10.1176/ajp.139.9.1136.
Ribeiro, O., Araújo, L., Teixeira, L., Brandão, D., Duarte, N. and Paúl, C. (2015). Oporto centenarian study. In Pachana NA, N. A. (ed.), Encyclopedia of Geropsychology. Singapure: Springer Science + Business Media. doi: 10.1007/978-981-287-080-3_141-1.
Rockwood, K. et al. (2005). A global clinical measure of fitness and frailty in elderly people. Canadian Medical Association Journal, 173, 489495. doi: 10.1503/cmaj.050051.
Rodrigues, R. M. C. (2008).Validação da versão em português europeu de questionário de avaliação funcional multidimensional de idosos. Revista Panamericana de Salud Pública, 23, 109115.
Rodriguez-Mañas, L. and Fried, L.P. (2015). Frailty in the clinical scenario, Lancet, 385, e7e9. doi:
Scheetz, L. T., Martin, P. and Poon, L. W. (2012). Do centenarians show higher levels of depression? Findings from the Georgia Centenarian Study. Journal of the American Geriatrics Society, 60, 238242. doi: 10.1111/j.1532-5415.2011.03828.x.
Strawbridge, W. J., Shema, S. J. and Balfour, J. L. (1998). Antecedents of frailty in three decades in an older cohort. The Journals of Gerontology, Series B: Psychological Sand Social Sciences, 53, S9S16.
Vaughan, L.,Corbin, A. L. and Goveas, J. S. (2015). Depression and frailty in later life: a systematic review. Clinical Interventions in Aging, 15, 19471958. doi: 10.2147/CIA.S69632.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed