Depression symptoms and risk of physical impairment: a systematic review and meta-analysis of cohort studies

Purpose Depression significantly impacts physical health, yet its influence on physical impairments among older adults warrants detailed exploration. This study aims to address the relationship between depression and physical limitations in older adults by analyzing findings from various research studies. Design/methodology/approach The study used specific inclusion and exclusion criteria. Eligible studies were prospective cohort studies where depression served as the exposure variable and physical impairment represented the outcome variable. A systematic review was conducted across two databases, namely, PubMed and Scopus, by the first author, while a third database, Google Scholar, was reviewed by the second author. Duplicate articles were subsequently screened for removal. Only articles written in English and published up to March 2018 were considered for inclusion. To identify potential publication bias, a combination of the Funnel plot, Egger’s test and the trim-and-fill method was used. In addition, a random-effects model was applied to synthesize the findings, and publication bias was thoroughly evaluated during the analysis process. Findings A total of 19 articles were identified following a review of published studies in databases up to March 2018. Findings indicated an association between depressive symptoms and physical impairment. Individuals experiencing depressive symptoms had a risk ratio of 1.54, with a 95% confidence interval (CI) ranging from 1.34 to 1.78. From a subset of studies, the pooled odds ratio across four studies was calculated as 2.21, with a 95% CI of 1.38 to 3.56, while the pooled hazard ratio from other four studies was found to be 1.44, with a 95% CI of 1.31 to 1.59. Evidence of heterogeneity and publication bias was observed. Originality/value This study suggests that depression may contribute to a heightened risk of physical impairment among older adults.