Depressive symptom severity is a major risk factor for frailty in community-dwelling older adults with depression—A prospective study
Depression and frailty are closely related, but the mechanisms by which depressed older adults are at an increased risk of becoming frail are still not well understood. The research assess essocioeconomic and depression-related risk factors for frailty in older adults with depression.
The researchers recruited and analysed 216 subjects (mean age 76.5 years; 74% women), 65 (30%) of whom were lost to follow-up. Observational and prospective cohort study, with 12-month follow-up, of nonfrail community-dwelling subjects aged ≥70 years old with depression. The main study factors were clinical characteristics of depression, including symptom severity (Hamilton Depression Rating Scale), accompanying anxiety and cognitive symptoms, pharmacological treatment, and social factors including educational level, income, housing conditions and living circumstances, and social network. Frailty status was established according to Fried criteria.
The multivariate analysis showed that age (odds ratio [OR] = 1.16; 95% confidence interval [CI]: 1.04–1.29), visual analogue scale (VAS)-pain (OR = 1.25; 95% CI: 1.01–1.55), and severe or very severe depressive symptoms (OR = 37.36; 95% CI: 2.68–518.53) were significantly associated with incident frailty at 12 months of follow-up. Both clinical and social characteristics are risk factors for frailty, but severity of depressive symptoms had the highest independent effect on frailty in depressed aged subjects.
Frailty requires a multidisciplinary approach that pays special attention to pain and depressed mood.