Poor Physical Performance Predicts Future Onset of Depression in Elderly People: Pro.V.A. Longitudinal Study

Reduced physical performance is predictive of deleterious outcomes in older adults. Data considering objective physical performance and incident depression is sparse. We investigated whether objective physical performance can predict incident depression among non-depressed older adults during a 4-year study. From 3,099 older individuals initially enrolled in the Progetto Veneto Anziani study, 970 participants without depression at baseline were included (mean age 72.5 years, 54.6% females). Physical performance measures included the Short Physical Performance Battery (SPPB), 4m gait speed, five times sit-to-stand test, leg extension and flexion, handgrip strength, and 6-Minute Walking Test (6MWT), categorized in gender-specific tertiles. Depression was classified based on the Geriatric Depression Scale (GDS) and a diagnosis from a geriatric psychiatrist. Area under the curve (AUC) and logistic regression analyses were conducted. At baseline, participants developing depression during follow-up (n = 207) scored significantly worse across all physical performance measures than those who did not develop depression. The AUC and predictive power for each physical performance test was similar for all the tests assessed. In logistic regression analysis, after adjusting for 14 potential confounders, worse physical performance across all tests increased the risk of depression. The lowest tertile of the SPPB were at notable odds of developing depression (OR = 1.79; 95%CI: 1.18-2.71). The association between poor physical performance and depression was typically stronger in women than in men, except for 4m gait speed. Limitations: no gold standard used for depression diagnosis; oxidative stress and inflammatory markers were not included; high rate of missing data at follow-up. Low physical performance appears to be an independent predictor of depression over a 4.4-year follow-up in our sample of elderly people