<b>Predictive Effect of Frailty and Quality of Life on Geriatric Depression in an Urban Community: A Cross-Sectional Study in Primary Health Care</b>

Background: Geriatric depression is a prevalent and multifactorial condition that can be influenced by aspects of frailty and quality of life (QoL) in older adults. In Brazil, there is a lack of studies that explore these factors in an integrated manner within the context of Primary Health Care (PHC). Objective: To analyze the predictive effect of frailty and QoL aspects on the presence of depression among community-dwelling older adults assisted in PHC in urban areas of low population density. Method: A cross-sectional, quantitative study involving 323 older adults registered in PHC units from two Brazilian municipalities. The instruments used were the Edmonton Frail Scale, the Short Form Health Survey, and the Geriatric Depression Scale. Analyses included association tests, Spearman’s correlation, and univariate and multivariate binary logistic regression. Results: There was a strong negative correlation between depression and the physical and mental health domains of QoL, particularly “mental health” (r = -0.53/ p < 0.001). Univariate binary logistic regression indicated that poorer scores in Self-perception of health (R² = 0.18/ p < 0.001/ OR [95% CI] = 3.62 [2.39–5.50]), Mood (R² = 0.24/ p < 0.001/ OR [95% CI] = 8.26 [4.56–14.95]), and Functional performance (R² = 0.08/ p < 0.001/ OR [95% CI] = 2.31 [1.56–3.42]) dimensions of Frailty were independent predictors of depression. However, when evaluated jointly in the multivariate analysis, Self-perception of health and Mood consistently increased the predictive effect (R² = 0.32). Conclusion: Negative self-perception of health and depressed mood within the frailty construct were the main predictors of depression, particularly when analyzed together. Although not included in the predictive models, QoL demonstrated relevant associations with the presence of depressive symptoms. These findings reinforce the importance of psychosocial and preventive approaches in PHC aimed at promoting the mental health of older adults.