Frailty as a Predictor of the Incidence and Course of Depressed Mood

Abstract

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.

Development of an application for mobile devices to identify the frailty phenotype among the elderly

“…In a study with health professionals regarding criteria to indicate frailty, it was noted that there were no uniformly determined criteria among such individuals, and that the data obtained was prone to subjectivity 17 , diverging from the most cited definitions in international literature 1,[18][19][20][21] . The use of the application can help in the identification of parameters for the evaluation of frailty, to reach a consensual and homogeneous definition.…”

Effectiveness of the interventions in preventing the progression of pre-frailty and frailty in older adults: a systematic review protocol

“…12,17 Furthermore, recent studies have shown that frailty may be related to mood change, 16,18 although the nature of this association, as well as its relevance to the frailty construct, needs to be clarified. 17 Regarding the prevalence of frailty, systematic comparison of numerous studies 19 shows that frailty in community-dwelling adults aged 65 and over varies from 4% to 17%.…”

Gait, Falls, and Dementia

“…70,71 Frailty is a predictor of depression. 72,73 This may be due to increased peripheral cytokines playing a role in the pathophysiology of depression. 74 Diabetes is associated with depression, falls, cognitive impairment, frailty, and gait instability.…”