الفهرس 
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Abstract
Frailty is a common geriatric syndrome with multiple negative health outcomes such as falls, reduced mobility, loss of independence, hospitalization, disability and death. Depression is another common health problem among elderly that affects quality of life significantly.
Depression and frailty have common risk factors, and both syndromes partially overlap that make distinguishing between them difficult.
Having symptoms of depression may increase the risk for frailty in older adults. Presence of depression in older adults will negatively affect their behaviors and activity levels and will result in a decrease in their social participation, deterioration in their functional status, and consequently an increase in frailty.
The aim of this study was to assess the relationship between depression and frailty among hospitalized older adults who were admitted to the Geriatrics hospital, at Ain Shams University Hospitals, Cairo, Egypt.
The study was a cross-sectional study that included a total 100 elderly participants (60 years and older), men and women, who were recruited from the inpatient unit of Geriatric hospital, at Ain Shams University hospitals. The participants were assessed and then subdivided, according to due presence or absence of frailty, into two groups: (a) case group that included fifty frail participants, and (b) control group that included fifty non-frail participants.
We excluded those patients who did not give a consent to participate in the study, patients who had delirium at the time of assessment, patients with significant cognitive impairment, patients with terminally ill medical condition, patients with any psychiatric disorder or substance abuse, and patients who were taking antidepressants.
All participants were subjected to Comprehensive geriatric assessment, including complete medical history and physical examination, cognitive assessment by the Arabic version of MMSE (mini-mental status examination), functional assessment by ADL (activities of daily living) and IADL (Instrumental activities of daily living). Assessment and diagnosis of depression was done according to DSM-IV criteria. Diagnosis of frailty was done according to the Edmonton Frail Scale (EFS).
Half (50%) of the total study participants were frail. Among these frail participants, 17% had severe frailty, 21% had moderate frailty, 12% had mild frailty. Prefrailty status was found in 13% were prefrail.
Assessment of depression among all study participants showed that 61% of the study participants were depressed. Major depression was found higher than minor depression (40% vs 2% respectively).
Results showed an association between frailty status with each of increasing age, lower educational level, and living alone either being divorced or widow. Also, an association was found between frailty and each of presence of hypertension, history of cerebrovascular stroke, poor nutritional status, risk of fall, and poor functional status.
Comparison between depressed and non-depressed participants showed that depression was associated with increasing age, female gender, and obesity. Also, depression was found to be associated with presence of co-morbidities such as COPD/asthma, poor nutritional status, increasing risk of fall, and poor functional level.
Comparison between frail and non-frail participants regarding presence of depression and depressive symptoms showed that there was a positive association between major depression and frailty. Comparison between the two groups regarding individual items of depression assessment criteria showed an association between frailty and each of item-1 (depressed mood), item-2 (loss of interest), and other items from 5 - 9 (psychomotor agitation or retardation, fatigue, feel of worthlessness, lack of concentration, and suicidal ideation.