Abstract

Background: This longitudinal cohort study aimed to determine whether mental health problems in midlife are linked to frailty after age 70, as measured using two sets of frailty criteria.

Methods: We used data from 27,958 adults aged 35-60 years in the Trøndelag Health Study (HUNT1, 1984-1986), with frailty outcomes assessed in 9,956 participants aged 70 years and older (HUNT4, 2017-2019). Mental health at baseline was self-reported. Frailty at follow-up was measured using both the Fried criteria and the 35-item HUNT4-Frailty Index. Linear regression models estimated frailty differences by baseline mental health status, adjusted for sociodemographic and lifestyle factors, stratified by age. We applied inverse probability weighting and multiple imputation to reduce selection bias.

Results: Mental health problems at age 35-49 at baseline were associated with 0.52 (95% CI: 0.35-0.69) higher Fried scores and 0.066 (95% CI: 0.048-0.084) higher HUNT4-FI scores at follow-up. For ages 50-60, Fried scores and HUNT4-FI scores were higher by 0.30 (95% CI: -0.02-0.63) and 0.037 (95% CI: 0.006-0.068), respectively.

Conclusion: We observed that midlife mental health problems were associated with higher frailty levels three decades later, across two commonly used frailty models. These findings underscore the importance of both psychological and physical factors in ageing.

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