Depression is associated with self-rated frailty in older adults from an outpatient clinic: a prospective study

Aprahamian, Ivan; Suemoto, Cláudia Kimie; Lin, Sumika Mori; Siqueira, Adriano Felipe Perez; Biella, Marina Maria; Melo, Brian Alvarez Ribeiro de; Jacob‐Filho, Wilson

doi:10.1017/s104161021800100x

Cited by 27 publications

(49 citation statements)

References 41 publications

(60 reference statements)

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“…Of note, results were only partially attenuated when using the modified CESD-10, which excluded fatigue-related items. Although depressive symptoms are correlated with increased risk of reduced functional ability [41][42][43], accurate early detection of depression remains challenging, especially for older adults who do not openly disclose their emotional status to their physician. Future studies should examine whether reporting lower energy may be an accurate indicator of underlying depressive symptoms.…”

Section: Discussionmentioning

confidence: 99%

Functional correlates of self-reported energy levels in the Health, Aging and Body Composition Study

et al. 2021

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Background Effects of fatigue on health in older age are well studied, yet little is known about the clinical relevance of energy perception. Aims To explore cross-sectional associations of self-reported energy with physical and mental health metrics in the Health, Aging, and Body Composition Study. Methods Participants rated their energy from 0 to 10; the outcome was energy dichotomized at the median (≥ 7 = higher energy). Four domains were assessed: depressive symptoms (Center for Epidemiologic Studies Depression Scale); physical performance (function: usual and rapid gait speed; fitness: 400-m walk time); physical activity (casual walking, walking for exercise, and intense exercise); and cognitive function (Modified Mini-Mental State Examination and Digit Symbol Substitution Test). Covariates bivariately associated with energy entered a multivariable logistic regression model, adjusted for demographics, chronic conditions, and strength. Results Depressive symptoms, physical performance and activity, but not cognition, were bivariately associated with energy (p < 0.0005). Younger age, male sex, greater strength, and absence of chronic conditions predicted higher energy (p < 0.001). In a multivariable model, depressive symptoms [adjusted odds ratio (aOR) 95% CI 0.69 (0.62, 0.76)] and 400-m walk times [aOR = 0.81 (0.72, 0.91)] were inversely associated with energy; usual and rapid gait speed [aOR = 1.3 (1.2, 1.4); aOR = 1.2 (1.1–1.4)], and time spent in intense exercise [aOR = 1.4 (1.1–1.7)] were positively associated with energy. Discussion In this cohort with a range of chronic conditions and fatigue, perceiving higher energy levels may reflect better emotional and physical health. Conclusion Energy should be considered in multidimensional clinical assessments of older age.

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Section: Discussionmentioning

confidence: 99%

Functional correlates of self-reported energy levels in the Health, Aging and Body Composition Study

et al. 2021

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“…The most frequently used instruments were the Center for Epidemiologic Studies-Depression (CES-D) and the Geriatric Depression Scale (GDS). Most of the studies whose samples comprised patients clinically diagnosed with depression were crosssectional [41][42][43][44][45][46] while a few were longitudinal 47,48 .…”

Section: Resultsmentioning

confidence: 99%

“…Two studies found that the presence of depression at baseline predicted frailty 37,48 . Both studies investigated depression together with the use of antidepressants and concluded an association with frailty after the follow-up period.…”

Section: Depression As a Predictor Of Frailty Over Timementioning

confidence: 99%

“…Results of a Brazilian study conducted in a geriatric outpatient clinic 48 assessing the association between depression treated with SSRI (selective serotonin reuptake inhibitors) and frailty showed a positive association between the syndromes at baseline and after 12-month follow-up. From the baseline analysis, the authors identified a significant association between depression and the two subdomains making up the frailty scale used (FRAIL): physical performance (muscle resistance and ambulation), and health status (fatigue, weight loss and number of illnesses).…”

Section: Depression As a Predictor Of Frailty Over Timementioning

confidence: 99%

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Depressão e fragilidade na velhice: uma revisão narrativa das publicações de 2008-2018

Nascimento

Batistoni

2019

Interface (Botucatu)

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Este artigo apresenta uma revisão narrativa da literatura sobre as relações entre depressão e fragilidade em idosos. Foram selecionados 28 artigos derivados da consulta às bases de dados LILACS, MEDLINE/PubMed e SciELO, publicados na última década (2008-2018). A análise da literatura evidenciou o predomínio de medidas de rastreio para depressão e do modelo conceitual do fenótipo de fragilidade. Observou-se a variação das associações entre as condições na presença de variáveis relativas: ao sexo, à funcionalidade física, cognitiva e aos aspectos socioemocionais, marcadores biológicos, uso de antidepressivos e risco de mortalidade. Os achados corroboram o impacto combinado das duas síndromes, que refletem maiores prejuízos para a saúde, maior vulnerabilidade e um perfil de alto risco. Embora consideradas síndromes distintas, estão fortemente associadas. Ressalta-se a escassez de dados nacionais que retratem o efeito combinado dos fenômenos na população idosa brasileira.

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“…Like frailty, late-life depression is an independent predictor of geriatric syndromes (e.g. falls, frailty) as well as disability, hospitalization, institutionalization, and death [19][20][21]. Several meta-analyses have shown that depression is an independent risk factor for the onset of hypertension, diabetes, stroke, heart disease, Alzheimer's disease, and cancer [19].…”

Section: Introductionmentioning

confidence: 99%

Design and protocol of the multimorbidity and mental health cohort study in frailty and aging (MiMiCS-FRAIL): unraveling the clinical and molecular associations between frailty, somatic disease burden and late life depression

et al. 2020

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Background To explore the mutual relationship between multimorbidity, mental illness and frailty, we have set-up the Multimorbidity and Mental health Cohort Study in FRAILty and Aging (MiMiCS-FRAIL) cohort. At the population level, multimorbidity, frailty and late-life depression are associated with similar adverse outcomes (i.e. falls, disability, hospitalization, death), share the same risk factors, and partly overlap in their clinical presentation. Moreover, these three variables may share a common underlying pathophysiological mechanism like immune-metabolic dysregulation. The overall objectives of MiMiCS-FRAIL are 1) to explore (determinants of) the cross-sectional and longitudinal relationship between multimorbidity, depression, and frailty among non-demented geriatric outpatients; 2) to evaluate molecular levels of senoinflammation as a broad pathophysiological process underlying these conditions; and 3) to examine adverse outcomes of multimorbidity, frailty and depression and their interconnectedness. Methods MiMiCS-FRAIL is an ongoing observational cohort study of geriatric outpatients in Brazil, with an extensive baseline assessment and yearly follow-up assessments. Each assessment includes a comprehensive geriatric assessment to identify multimorbidity and geriatric syndromes, a structured psychiatric diagnostic interview and administration of the PHQ-9 to measure depression, and several frailty measures (FRAIL, Physical Phenotype criteria, 36-item Frailty Index). Fasten blood samples are collected at baseline to assess circulating inflammatory and anti-inflammatory cytokines, leukocytes' subpopulations, and to perform immune-metabolic-paired miRome analyses. The primary outcome is death and secondary outcomes are the number of falls, hospital admissions, functional ability, well-being, and dementia. Assuming a 5-year mortality rate between 25 and 40% and a hazard rate varying between 1.6 and 2.3 for the primary determinants require a sample size between 136 and 711 patients to detect a statistically significant effect with a power of 80% (beta = 0.2), an alpha of 5% (0.05), and an R2 between the predictor (death) and all covariates of 0.20. Local ethical board approved this study. Discussion Frailty might be hypothesized as a final common pathway by which many clinical conditions like depression and chronic diseases (multimorbidity) culminate in many adverse effects. The MiMiCS-FRAIL cohort will help us to understand the interrelationship between these variables, from a clinical perspective as well as their underlying molecular signature.

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Depression is associated with self-rated frailty in older adults from an outpatient clinic: a prospective study

Abstract: It appears that depression with SSRI is associated to frailty, and this association cannot be explained only by antidepressant use.

Cited by 27 publications

References 41 publications

Functional correlates of self-reported energy levels in the Health, Aging and Body Composition Study

Functional correlates of self-reported energy levels in the Health, Aging and Body Composition Study

Depressão e fragilidade na velhice: uma revisão narrativa das publicações de 2008-2018

Design and protocol of the multimorbidity and mental health cohort study in frailty and aging (MiMiCS-FRAIL): unraveling the clinical and molecular associations between frailty, somatic disease burden and late life depression

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