Author(s): SHIMABUKURO, T., KURIHARA, T., KISHIGAMI, K., HASHIMOTO, K., ISHIDA, M., MURAKAMI, Y., NAGAMATSU, M., HASHIMOTO, T., IEMITSU, M., IMAI, A., SANADA, K., Institution: RITSUMEIKAN UNIVERSITY BIWAKO KUSATSU CAMPUS, Country: JAPAN, Abstract-ID: 844

INTRODUCTION:
Depressive symptoms (DS) are associated with declines in physical function (PF), and exercise has been shown to be effective for the prevention of DS1. In addition, social frailty (SF) has been reported as one of the strongest risk factors for DS in older adults2. Furthermore, group-based exercise has been reported to confer greater health benefits than exercising alone.³ However, evidence regarding the association among PF, social factors, and DS remains limited. Therefore, this study examined the associations between PF—including hand grip strength (HGS), the five-times chair stand test (5CST), and the 2-step test—and DS, stratified by SF status.
METHODS:
This cross-sectional study included 297 community-dwelling older adults aged ≥65 years (age: 74.8 ± 6.2 years; women: n = 188). Participants were classified as follows: HGS (men <28 kg, women <18 kg)4, 5CST (≥12 s)4, and the 2-step test into four categories based on the ratio of stride length to height5. SF was assessed using the scale proposed by Makizako et al.⁶ In addition, DS were evaluated using the Japanese version of the 15-item Geriatric Depression Scale 15 (GDS-15-J)7. Two-way ANCOVA was performed with PF and SF as independent variables and the GDS-15-J score as the dependent variable, adjusting for age, sex, and BMI.
RESULTS:
Main effects of lower PF linked to higher GDS-15-J scores (HGS: P = 0.038; 5CST: P < 0.001; two-step test: P < 0.001). In addition, SF showed a strong main effect across all PF measures (P < 0.001), indicating higher GDS-15-J scores among participants with SF. No significant interaction effects between PF and SF were observed.
CONCLUSION:
HGS, 5CST, and the 2-step test were associated with DS. However, regardless of the type or severity of PF decline, the presence of SF was consistently associated with higher GDS-15-J scores. These findings suggest that, in addition to exercise-based interventions, addressing SF may be essential for DS prevention in community-dwelling older adults.

References
1. Singh et al, A Randomized Controlled Trial of High Versus Low Intensity Weight Training Versus General Practitioner Care for Clinical Depression in Older Adults. 2005
2. Li et al, Prevalence and potential influencing factors for social frailty among community-dwelling older adults: a systematic review and meta-analysis. 2024
3. Kanamori et al, Exercising alone versus with others and associations with subjective health status in older Japanese: The JAGES Cohort Study. 2016
4. Chen et al, Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. 2020
5. Tanaka et al, Clinical prediction rule for locomotive syndrome in older adults: A decision tree model. 2023
6. Makizako et al, Social Frailty in Community-Dwelling Older Adults as a Risk Factor for Disability. 2015
7. Sugishita et al, A Validity and Reliability Study of the Japanese Version of the Geriatric Depression Scale 15 (GDS-15-J). 2017