ArticleFrontiers in public health2026
Grip strength in the association between frailty and new-onset depression in older adults: a multinational longitudinal study.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Frailty is a multidimensional geriatric syndrome characterized by cumulative physiological decline. While associated with various adverse outcomes, the longitudinal relationship between frailty and new-onset depression across diverse national populations remains insufficiently explored. This study investigated the association between the Frailty Index (FI) and new-onset depression in three large aging cohorts. Methods: This multinational longitudinal cohort study included community-dwelling adults aged ≥50 years from three nationally representative aging cohorts: the Health and Retirement Study (HRS), the English Longitudinal Study of Aging (ELSA), and the Survey of Health, Aging and Retirement in Europe (SHARE). Frailty was assessed using a deficit accumulation-based frailty index (FI). New-onset depression was defined by validated CES-D 8 or EURO-D scores among participants free of depression at baseline. Associations were estimated using Cox proportional hazards, Fine-Gray competing risk, and discrete-time logistic regression models. Dose-response patterns were examined using restricted cubic splines, and mediation analysis evaluated the role of grip strength. Results: Over median follow-ups of 8 (HRS), 2 (ELSA), and 4 (SHARE) years, 749, 973, and 7,821 participants developed new-onset depression, respectively. Cohort-specific incidence rates were 34.5% in HRS (749/2, 171), 18.6% in ELSA (973/5, 223), and 30.4% in SHARE (7, 821/25, 721). Adjusted analyses showed the FI was consistently associated with depression risk across all cohorts. Each one-unit FI increase was associated with an approximately 4% higher risk (HR = 1.04, Conclusion: Frailty is an independent predictor of new-onset depression in older adults across diverse international populations. Early frailty identification and targeted multidimensional interventions-including grip strength enhancement, structured physical activity, nutritional optimization, and psychosocial support-may help reduce depression incidence and promote healthy aging.
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