The inter-relationship between depressed mood, functional decline and disability over a 10-year observational period within the Longitudinal Urban Cohort Ageing Study (LUCAS)

Abstract

BackgroundThe WHO defines ‘healthy ageing’ as ‘the process of developing and maintaining the functional ability’. Late-life depression and frailty compromise well-being and independence of older people. To date, there exists little research on the interaction of the dynamic processes of frailty and depression and only a few studies were longitudinal. Conclusions about the direction of effects remained uncertain.MethodsData were obtained from each of the last six biyearly waves (2007–2017) of the Longitudinal Urban Cohort Ageing Study (LUCAS) in Hamburg, Germany, a prospective observational cohort study of manifold aspects of ageing. Screening of predictor and event variables: depressed mood: one question from the 5-item Mental Health Inventory Screening Test; frailty: LUCAS Functional Ability Index, status ‘frail’; disability: one question on need for human help with basic activities of daily living. Kaplan-Meier curves and Cox’s proportional hazards regression were used for time-to-event analyses with shifting baseline.ResultsSample size in 2007 was 2012, average age 76.2 years; ±6.5. Main results were as follows: (1) depression significantly increased the hazard of subsequent frailty (HR=1.581; 95% CI 1.257 to 1.988; p<0.001); (2) frailty significantly increased the hazard of subsequent depression (HR=2.324; 95% CI 1.703 to 3.172; p<0.001); (3) depression significantly increased the hazard of subsequent disability (HR=2.589; 95% CI 1.885 to 3.557; p<0.001) and (4) disability did not significantly increase the hazard of subsequent depression (HR=1.540; 95% CI 0.917 to 2.579; p=0.102).ConclusionOur results suggest an interdependence of the processes of depression and frailty/disability rather than unidirectional dependencies. These observable processes may be representative of underlying unobservable profound life changes. Obviously, there is a need for early screening to initiate appropriate interventions.

Functional Status in Relation to Common Geriatric Syndromes and Sociodemographic Variables – A Step Forward Towards Healthy Aging

“…Either way, depression is a risk factor for functional decline and disability and vice versa and this dynamic long-term interdependence between them is crucial to supporting the view that regular screening for depressed mood and incipient functional decline may help to initiate early and appropriate interventions. 40 , 41 …”

Heat Perception and Coping Strategies: A Structured Interview-Based Study of Elderly People in Cologne, Germany

“…Only people without daily need of assistance or professional care were included into the variable [ 50 ]. The index has been used in several publications on frailty, functional decline, and disability in the setting of community-dwelling older adults [ 51 , 52 ].…”

Prevalence of Prefrailty and Frailty Among Older Adults in Germany: A Systematic Review, Meta-Analysis and Meta-Regression

“…In sum, a number of 12 studies were included in our systematic review-and also in meta-analysis. In Table 2, a study overview that includes the main findings is given (10,18,20,21,(23)(24)(25)(26)(27)(28)(29)(30).…”

“…A total of six studies were longitudinal (where we used the prevalence at baseline for meta-analysis) (10,(23)(24)(25)28), whereas the other six studies were cross-sectional. Data were mainly used from the well-known German studies (e.g., "German Health Interview and Examination Survey for Adults" or "Quality of Life and Well-Being of the Very Old in North Rhine-Westphalia").…”