Frailty is common in later life, but different operationalization of frailty status results in widely differing prevalence between studies. Improving the comparability of epidemiological and clinical studies constitutes an important step forward.

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A quarter of depressed older patients is physically frail, especially the most depressed group. This cannot be explained by overlap in criteria and should be examined in future studies, primarily on its presumed clinical relevance.

In order to assess the impact of eczema on the lives of affected individuals a postal questionnaire was sent to all members of the National Eczema Society (NES). The survey also sought to ascertain their expectations of their initial consultation with general practitioners and hospital doctors; to assess their satisfaction with these consultations; to obtain their views on the treatment prescribed, and their reasons for joining the NES. Information on 1972 adults (614 male, 1358 female) and from 1944 parents of affected children was received, representing an overall response rate of 29%. The work of 1061 (54%) adults, and the choice of career of 391 (20%) had been affected. Eczema affected the ability to perform domestic duties in 1128 (83%) women compared with 439 (71%) men. Social and leisure activities were affected in 1269 (64%) of adults. The development of personal relationships had been impaired in 273 (14%), and the sex lives of 373 (19%) had been affected. In children sleep (60%) was the most commonly affected activity. The expectations of the initial consultation with their general practitioner of 659 (17%) had not at all been met, of 2528 (65%) partly met, and of only 483 (12%) completely met; 2638 patients had seen a hospital specialist. The expectations of 478 (18%) had not at all been met, of 1164 (62%) partly met, and of only 512 (19%) completely met. Forty-four per cent (1713) were either 'extremely satisfied' or 'satisfied' with the treatments they had been given, 1529 (40%) were 'neutral', 480 (12%) were dissatisfied, and 103 (2.6%) were extremely dissatisfied.(ABSTRACT TRUNCATED AT 250 WORDS)

Background Late-life depression and physical frailty are supposed to be reciprocally associated, however, longitudinal studies are lacking. Objectives This study examines whether physical frailty predicts a higher incidence of depression, as well as a less favorable course of depression. Methods A population-based cohort study of 888 people aged 65 years and over with follow-up measures at 3, 6, and 9 years. Cox proportional hazards models adjusted for age, sex, education, smoking, alcohol usage, and global cognitive functioning were applied to calculate the incidence of depressed mood in those nondepressed at baseline (n = 699) and remission in those with depressed mood at baseline (n = 189). Depressed mood onset or remission was defined as crossing the cut-off score of 20 points on the Center for Epidemiological Studies-Depression Scale combined with a relevant change in this score. Physical frailty was based on the presence of ≥3 out of 5 components (ie, weight loss, weakness, slowness, exhaustion, and low physical activity level). Results A total of 214 out of 699 (30.6%) nondepressed persons developed depressed mood during follow-up. Physical frailty predicted the onset of depressed mood with a hazard rate of 1.26 (95% confidence interval 1.09–1.45, P = .002). Of the 189 persons with depressed mood at baseline, 96 (50.8%) experienced remission during follow-up. Remission was less likely in the presence of a higher level of physical frailty (hazard rate = 0.72, 95% confidence interval 0.58–0.91, P = .005). Conclusions Because physical frailty predicts both the onset and course of late-life depressed mood, physical frailty should receive more attention in mental health care planning for older persons as well as its interference with treatment. Future studies into the pathophysiological mechanisms may guide the development of new treatment opportunities for these vulnerable patients.

Prevalence of somatoform disorders and medically unexplained symptoms in old age populations in comparison with younger age groups Hilderink, P. H.; Collard, R.; Rosmalen, Judith; Oude Voshaar, Richard C. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. a b s t r a c tObjective: To review current knowledge regarding the prevalence of somatization problems in later life by level of caseness (somatoform disorders and medically unexplained symptoms, MUS) and to compare these rates with those in middle-aged and younger age groups. Method: A systematic search of the literature published from 1966 onwards was conducted in the Pubmed and EMBASE databases.Results: Overall 8 articles, describing a total of 7 cohorts, provided data of at least one prevalence rate for somatoform disorders or MUS for the middle-aged (50-65 years) or older age (≥65 years) group. Prevalence rates for somatoform disorders in the general population range from 11 to 21% in younger, 10 to 20% in the middle-aged, and 1.5 to 13% in the older age groups. Prevalence rates for MUS show wider ranges, of respectively 1.6-70%, 2.4-87%, and 4.6-18%, in the younger, middle, and older age groups, which could be explained by the use of different instruments as well as lack of consensus in defining MUS. Conclusion: Somatoform disorders and MUS are common in later life, although the available data suggest that prevalence rates decline after the age of 65 years. More systematic research with special focus on the older population is needed to understand this age-related decline in prevalence rates.

Physical frailty negatively impacts the course of late-life depression. Since only improvement of mood symptoms was independent of frailty severity, one may hypothesize that frailty and residual depression are easily mixed-up in psychiatric treatment.

The long-term prognosis of late-life depression is poor with regard to mortality and course of depression. Chronic diseases, loneliness, and pain may be used as putative targets for optimizing prevention and treatment strategies for relapse and chronicity.