Abstract
Objectives
Cognitive frailty has recently been defined as the co-occurrence of physical frailty
and cognitive impairment. Late-life depression is associated with both physical frailty
and cognitive impairment, especially processing speed and executive functioning. The
objective of this study was to investigate the association between physical frailty
and cognitive functioning in depressed older persons.
Design
Baseline data of a depressed cohort, participating in the Netherlands Study of Depression
in Older persons (NESDO).
Setting
Primary care and specialized mental health care.
Participants
A total of 378 patients (≥60 years) with depression according to DSM-IV criteria and
a MMSE score of 24 points or higher.
Measurements
The physical frailty phenotype as well as its individual criteria (weight loss, weakness,
exhaustion, slowness, low activity). Cognitive functioning was examined in 4 domains:
verbal memory, working memory, interference control, and processing speed.
Results
Of the 378 depressed patients (range 60–90 years; 66.1% women), 61 were classified
as robust (no frailty criteria present), 214 as prefrail (1 or 2 frailty criteria
present), and 103 as frail (≥3 criteria). Linear regression analyses, adjusted for
confounders, showed that the severity of physical frailty was associated with poorer
verbal memory (ß = −0.13, P = .039), slower processing speed (ß = −0.20, P = .001), and decreased working memory (ß = −0.18, P = .004), but not with changes in interference control (ß = 0.04, P = .54).
Conclusion
In late-life depression, physical frailty is associated with poorer cognitive functioning,
although not consistently for executive functioning. Future studies should examine
whether cognitive impairment in the presence of physical frailty belongs to cognitive
frailty and is indeed an important concept to identify a specific subgroup of depressed
older patients, who need multimodal treatment strategies integrating physical, cognitive,
and psychological functioning.
Keywords
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Article info
Publication history
Published online: September 01, 2015
Footnotes
The authors declare no conflicts of interest.
The infrastructure of the NESDO study (http://nesdo.amstad.nl) is funded through the Fonds NutsOhra, Stichting tot Steun VCVGZ, NARSAD, The Brain and Behaviour Research Fund, and the participating universities and mental health care organizations (VU University Medical Center, Leiden University Medical Center, University Medical Center Groningen, University Medical Center St Radboud, GGZinGeest, GGNet, GGZ Nijmegen, GGZ Rivierduinen, Lentis, and Parnassia).
Identification
Copyright
© 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
