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The Relationship between Psychological Distress and Physical Frailty in Japanese Community-Dwelling Older Adults: A Cross-Sectional Study

  • Original Research
  • Neurosciences of frailty
  • Published:
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Abstract

Background

Older adults’ mental health and physical frailty have been a frequent research focus, but few studies have investigated the relationship between them.

Objectives

To investigate the association between mental health and physical frailty in community-dwelling older Japanese people.

Design

Cross-sectional study from the Itoshima Frail Study.

Setting

Itoshima City, Fukuoka, Japan.

Participants

A total of 919 community-dwelling older individuals aged 65–75 years.

Measurements

Physical frailty was measured based on five criteria proposed by the Fried scale, and the subjects were classified into three groups: robust, pre-frailty, and frailty. Psychological distress was used to assess the subjects’ mental health, with the Kessler 6-Item Psychological Distress Scale (K6) score; the subjects were divided into three groups based on their K6 score: 0–1, 2–4, and ≥5. Psychological distress was defined by K6 score ≥5. Ordinal logistic regression was used to estimate the odds ratios (OR) and 95% confidence intervals (CIs) between the psychological distress and physical frailty status.

Results

Psychological distress was identified in 190 subjects (20.7%). Forty-six subjects (5.0%) presented with physical frailty, and 24 subjects (2.6%) had both psychological distress and physical frailty. With the increase in the K6 score, more subjects had pre-frailty and physical frailty (p<0.001). Significant positive associations were observed between psychological distress and the risks of pre-frailty (OR 2.94, 95%CI: 1.95–4.43) and frailty (OR 10.71, 95%CI: 4.68–24.51), even in a multivariable-adjusted analysis. In a subgroup analysis of components of frailty, one-point increment in K6 score was associated with higher odds of shrinking and fatigue.

Conclusion

A severe psychological distress was associated with increased risks of physical frailty and the frailty sub-items of shrinking and fatigue in community-dwelling older Japanese adults.

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Data Availability Statement: All of the study data can be obtained from the corresponding author upon reasonable request.

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Acknowledgements

We thank all of the subjects, the Itoshima City office for their support of the participant recruitment, and Emeritus Professor Shuzo Kumagai, the initiator of this study.

Funding

Funding Sources: This study was supported in part by Grants-in-Aid for Scientific Research (B) (nos. JP20H04016 and JP20H04030) and (C) (nos. JP20K102692, JP20K11446, and JP20K12510) and for Activity Start-up (no. JP19K24259) from the Ministry of Education, Culture, Sports, Science and Technology of Japan; by Itoshima City (2021-0032), Asanohi Orthopaedic Clinic (2020-0528) and NTT docomo Inc. (2021-0085). None of the funding sources had any role in the study design, data analysis, data interpretation, writing of the manuscript, or decision on the submission of this manuscript.

Author information

Authors and Affiliations

  1. Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka City, Fukuoka, Japan

    X. Liu, T. Chu &  Hiro Kishimoto

  2. Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai, China

    T. Chen

  3. School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China

    S. Chen

  4. Faculty of Arts and Science, Kyushu University, IC15, 744 Motooka Nishi-ku, Fukuoka City, Fukuoka, 819-0395, Japan

    H. Yatsugi &  Hiro Kishimoto

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Contributions

Author Contributions: All authors contributed to the data analysis, the drafting and revision of the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Hiro Kishimoto.

Ethics declarations

Statement of Ethics: This study was approved by the Institutional Review Board of Kyushu University, Japan (approval no. 201708, Principal Investigator: Shuzo Kumagai). All participants provided written informed consent.

Conflict of Interest Statement: The authors report no conflicts of interest related to this article.

Electronic supplementary material

Suppl. Table S1

. Associations between K6 score and the risk of frailty score (four domains without fatigue)

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Liu, X., Chen, T., Chen, S. et al. The Relationship between Psychological Distress and Physical Frailty in Japanese Community-Dwelling Older Adults: A Cross-Sectional Study. J Frailty Aging 12, 43–48 (2023). https://doi.org/10.14283/jfa.2022.63

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