Depression and frailty in later life: a synthetic review

Abstract

Background Many of the symptoms, consequences, and risk factors for frailty are shared with late-life depression. However, thus far, few studies have addressed the conceptual and empirical interrelationships between these conditions. This review synthesizes existing studies that examined depression and frailty among older adults and provides suggestions for future research. Methods A search was conducted using PubMed for publications through 2010. Reviewers assessed the eligibility of each report and abstracted information on study design, sample characteristics, and key findings, including how depression and frailty were conceptualized and treated in the analysis. Results Of 133 abstracted articles, 39 full-text publications met inclusion criteria. Overall, both cross-sectional (n = 16) and cohort studies (n = 23) indicate that frailty, its components, and functional impairment are risk factors for depression. Although cross-sectional studies indicate a positive association between depression and frailty, findings from cohort studies are less consistent. The majority of studies included only women and non-Hispanic Whites. None used diagnostic measures of depression or considered antidepressant use in the design or analysis of the studies. Conclusions A number of empirical studies support for a bidirectional association between depression and frailty in later life. Extant studies have not adequately examined this relationship among men or racial/ethnic minorities, nor has the potential role of antidepressant medications been explored. An interdisciplinary approach to the study of geriatric syndromes such as late-life depression and frailty may promote cross-fertilization of ideas leading to novel conceptualization of intervention strategies to promote health and functioning in later life.

Pain in older people with frailty

“…Mood state can impact on persistent pain and older people with frailty experience more anxiety and depression than non-frail people 16,33 . The extent to which this is related to more frequent external stresses such as the loss of friends, or family support, or a greater reaction to these losses due to the abnormal health state of frailty and impaired resilience is unclear.…”

“…Whilst these indicators demonstrate high sensitivity for the identification of frailty, they have poor specificity 15 and are therefore unsuitable for epidemiological research. Mood (anxiety and depression) was also included as an outcome of interest as frailty and its associated functional impairment are risk factors for depression 16 Analgesic outcomes were also identified.…”

Cognitive frailty: Rational and definition from an (I.A.N.A./I.A.G.G.) International Consensus Group

“…For example, depression has been related to hippocampal atrophy and subsequent mild cognitive impairment (MCI) (38) as well (39,40). Similarly, cardiovascular risk factors (e.g.…”

Experience of Frailty in Korean Elderly: A Phenomenological Study Utilizing the Colaizzi Method

“…또한 노인의 허약은 노인의 주관적 건 강과 건강관련 삶의 질 및 노년기 발달과제인 자아통합감에도 영향 을 주는 요인이다 [12]. 이밖에 노인은 만성 질병의 수가 많을수록 [12,15], 복용하는 약물 의 개수가 많을수록 [16], 우울한 노인일수록 더 허약하다고 하였다 [17,18]. 또 허약은 인지 능력이 낮은 노인에게 더 호발된다고 보고되 고 있다 [19].…”