MULTI-DOMAINS LIFESTYLE INTERVENTIONS REDUCES DEPRESSIVE SYMPTOMS AMONG FRAIL AND PRE-FRAIL OLDER PERSONS: RANDOMIZED CONTROLLED TRIAL

Background: We investigated the effect of multi-domain lifestyle (physical, nutritional, cognitive) interventions among frail and pre-frail community-living older persons on reducing depressive symptoms. Method: Participants aged 65 and above were randomly allocated to 24 weeks duration interventions with nutritional supplementation (N=49), physical training (N=48), cognitive training (N=50), combination intervention (N=49) and usual care control (N=50). Depressive symptoms were assessed by the Geriatric Depression Scale (GDS-15) at baseline (0M), 3 month (3M), 6 month (6M) and 12 month (12M). Results: Mean GDS scores in the control group increased from 0.52 (0M) and 0.54 (3M) to 0.74 (6M), and 0.83 (12M). Compared to the control group, interventions showed significant differences (Delta=change) at 6M for cognitive versus control (Delta=-0.39, p=0.021, group*time interaction p=0.14); physical versus control (Delta=-0.37, p=0.026, group*time interaction p=0.13),and at 12M for nutrition versus control (Delta =-0.46, p=0.016, group*time interaction p=0.15). The effect for combination versus control was significant at 6M (Delta=-0.43, p=0.020) and 12M (Delta=-0.51, p=0.005, group*time interaction p=0.026). Estimated 12-month cumulative incidence of depressive symptoms (GDS=2) relative to control were OR=0.38, p=0.037 (nutrition); OR=0.71, p=0.40 (cognitive); OR=0.39, p=0.042 (physical training) and OR=0.38, p=0.037 (combination). Changes in gait speed and energy level were significantly associated with changes in GDS scores over time. Conclusion: Multi-domain interventions that reverse frailty among community-living older persons also reduce depressive symptomatology. Public health education and programmatic measures combining nutritional, physical and cognitive interventions for at-risk frail older people may likely benefit psychological wellbeing.