Relationship among frailty, nutrition, depression and quality of life in the older population

Abstract Background Frailty is strongly associated with adverse outcomes including depression, cognitive decline, falls, and reduced quality of life. Frailty is an important indicator of older individuals’ health status and healthcare needs. This study aims to examine the relationship among frailty, nutrition, depression, and quality of life in individuals aged 65 years and over living in the community. Methods This descriptive correlational study was conducted between June 2022 to May 2023 at a family health center with 283 older adults (≥ 65 years) selected via full enumeration. Data were collected using validated tools, including the Tilburg Frailty Indicator, Mini Nutritional Assessment, and scales for depression and quality of life. Analyses involved descriptive statistics, parametric/non-parametric tests, factor analyses, and reliability assessments using SPSS 25® and AMOS. Results This study analyzed 283 older adults (mean age: 70.71 ± 5.58 years; 57.6% female). Frailty affected 71% of participants, with higher scores among older individuals, women, single participants, and those with chronic diseases (p < 0.01). Frailty correlated with depression (r = 0.722, p < 0.01) and lower quality of life (r=-0.650, p < 0.01), predicting reduced quality of life (β=-0.596, p = 0.005). Depression was the strongest determinant of poor quality of life (β=-0.620, p < 0.001). Nutrition was positively associated with quality of life (r = 0.583, p < 0.01) but not an independent predictor (p > 0.05). Together, frailty, depression, and nutrition explained 59% of the variance in quality of life. Validation of the Depression in Old Age Scale confirmed it as a unidimensional tool. Conclusion This study highlights a high prevalence of frailty among older adults, with depression emerging as a critical determinant. Frailty scores increased with rising depression levels, and both frailty and depression were significant predictors of reduced quality of life.