Abstract
Objective
There is a lack of studies disentangling whether changes in frailty are associated
with subsequent changes in depressive symptoms or vice versa among the oldest old.
Consequently, we aimed to disentangle this link.
Design
Three waves [follow-up (FU) wave 7 to FU wave 9; n = 423 individuals in the analytical
sample] were used from the multicenter prospective cohort study “Needs, Health Service
Use, Costs and Health-Related Quality of Life in a Large Sample of Oldest-Old Primary
Care Patients (85+)” (AgeQualiDe).
Setting and Participants
Primary care patients aged 85 years and older.
Methods
The Canadian Study of Health and Aging (CSHA) Clinical Frailty Scale (CFS) was used
to quantify frailty, and the Geriatric Depression Scale was used to measure depressive
symptoms. It was adjusted for several covariates (sociodemographic and health-related
factors) in regression analysis.
Results
Multiple linear regressions with first differences showed that initial increases in
depressive symptoms (from FU wave 7 to FU wave 8) were associated with subsequent
increases in frailty (from FU wave 8 to FU wave 9; β = 0.06, P < .05), whereas initial increases in frailty (from FU wave 7 to FU wave 8) were not
associated with subsequent increases in depressive symptoms (from FU wave 8 to FU
wave 9).
Conclusions and Implications
The study findings suggest the relevance of increases in depressive symptoms for subsequent
increases in frailty. Treatment of depressive symptoms may also be beneficial to postpone
frailty.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the American Medical Directors AssociationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Frailty in elderly people.Lancet. 2013; 381: 752-762
- Longitudinal predictors of institutionalization in old age.PLoS One. 2015; 10: e0144203
- Sex differences in the risk of frailty for mortality independent of disability and chronic diseases.J Am Geriatr Soc. 2005; 53: 40-47
- Association of the clinical frailty scale with hospital outcomes.QJM. 2015; 108: 943-949
- The association of falls with loneliness and social exclusion: Evidence from the DEAS German Ageing Survey.BMC Geriatr. 2017; 17: 204
- Frailty: An emerging geriatric syndrome.Am J Med. 2007; 120: 748-753
- Age-and gender-specific prevalence of depression in latest-life—Systematic review and meta-analysis.J Affect Disord. 2012; 136: 212-221
- The relationship between generalized anxiety disorder, depression and mortality in old age.Int J Geriatr Psychiatry. 2007; 22: 241-249
- The impact of depressive symptoms on healthcare costs in late life: Longitudinal findings from the AgeMooDe study.Am J Geriatr Psychiatry. 2017; 25: 131-141
- Relationship between depression and frailty in older adults: A systematic review and meta-analysis.Aging Res Rev. 2017; 36: 78-87
- Frailty: Emergence and consequences in women aged 65 and older in the Women's Health Initiative Observational Study.J Am Geriatr Soc. 2005; 53: 1321-1330
- Disentangling the complex relation of disability and depressive symptoms in old age—Findings of a multicenter prospective cohort study in Germany.Int Psychogeriatr. 2017; 29: 885-895
- Vascular depression: An early warning sign of frailty.Aging Ment Health. 2013; 17: 85-93
- Frailty predicts new and persistent depressive symptoms among community-dwelling older adults: Findings from Singapore longitudinal aging study.J Am Med Dir Assoc. 2014; 15 (76.e7-76.e12)
- Physical frailty predicts incident depressive symptoms in elderly people: Prospective findings from the Obu Study of Health Promotion for the Elderly.J Am Med Dir Assoc. 2015; 16: 194-199
- Spousal associations between frailty and depressive symptoms: Longitudinal findings from the cardiovascular health study.J Am Geriatr Soc. 2016; 64: 824-830
- Ist Psychotherapie bei depressiven Erkrankungen im Alter wirksam?.Psychiatrische Praxis. 2014; 41 ([Are psychotherapeutic interventions effective in late-life depression?]): 415-423
- Factors associated with improvement in frailty status defined using the frailty phenotype: A systematic review and meta-analysis.J Am Med Dir Assoc. 2019; 20: 1647-1649.e2
- Determinants of health-related quality of life in older primary care patients: Results of the longitudinal observational AgeCoDe Study.Br J Gen Pract. 2015; 65: e716-e723
- A global clinical measure of fitness and frailty in elderly people.CMAJ. 2005; 173: 489-495
- Is trunk posture in walking a better marker than gait speed in predicting decline in function and subsequent frailty?.J Am Med Dir Assoc. 2016; 17: 65-70
- Measuring frailty can help emergency departments identify independent seniors at risk of functional decline after minor injuries.J Gerontol A Biol Sci Med Sci. 2017; 72: 68-74
- Impact of hypoalbuminemia, frailty, and body mass index on early prognosis in older patients (≥ 85 years) with ST-elevation myocardial infarction.J Cardiol. 2015; 66: 263-268
- Validation of the Chinese-Canadian study of health and aging clinical frailty scale (CSHA-CFS) telephone version.Arch Gerontol Geriatr. 2010; 50: e74-e80
- Reliability of frailty assessment in the critically ill: A multicentre prospective observational study.Anaesthesia. 2019; 74: 7
- Measures of frailty in population-based studies: An overview.BMC Geriatr. 2013; 13: 64
- 9/Geriatric Depression Scale (GDS) recent evidence and development of a shorter violence.Clin Gerontologist. 1986; 5: 165-173
- The criterion validity of the Geriatric Depression Scale: A systematic review.Acta Psychiatr Scand. 2006; 114: 398-410
- Development and validation of a geriatric depression screening scale: A preliminary report.J Psychiatr Res. 1982; 17: 37-49
- The impact of social engagement on health-related quality of life and depressive symptoms in old age—Evidence from a multicenter prospective cohort study in Germany.Health Qual Life Outcomes. 2017; 15: 140
- Predictors of frailty in old age—Results of a longitudinal study.J Nutr Health Aging. 2016; 20: 952-957
- Functional evaluation: The Barthel index.Md State Med J. 1965; 14: 61-65
- Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations.Gerontologist. 2006; 46: 503-513
- The Global Deterioration Scale for assessment of primary degenerative dementia.Am J Psychiatry. 1982; 139: 1136-1139
- Educational reform in France, West-Germany and the United Kingdom: Updating the CASMIN educational classification.Zuma Nachrichten. 1999; 23: 7-44
- Microeconometrics: Methods and Applications.Cambridge University Press, Cambridge2005
- Fixed-effects panel regression.in: Wolf C. The SAGE Handbook of Regression Analysis and Causal Inference. Sage, Los Angeles, CA2015
- Fixed effects analysis of repeated measures data.Int J Epidemiol. 2013; 43: 264-269
- Vector autoregressions.J Econ Perspect. 2001; 15: 101-115
- Complex coevolution of depression and health-related quality of life in old age.Qual Life Res. 2015; 24: 2713-2722
- Führt eine Zunahme depressiver Symptome zu einer Zunahme funktioneller Einschränkungen oder vice versa? Ergebnisse der AgeCoDe/AgeQualiDe-Studie.Psychiat Prax. 2020; 47: 148-153
- Frailty and depression in older adults: A high-risk clinical population.Am J Geriatr Psychiatry. 2014; 22: 1083-1095
- Depression and frailty: The need for multidisciplinary research.Am J Geriatr Psychiatry. 2004; 12: 1-5
- Depression and frailty in later life: A systematic review.Clin Interv Aging. 2015; 10: 1947
- Construct overlap between depression and frailty in later life: Evidence from the health and retirement study.Compr Psychiatry. 2013; 1: e6
- Frailty in the elderly: Contributions of sarcopenia and visceral protein depletion.Metabolism. 2003; 52: 22-26
- Cognitive remission: A novel objective for the treatment of major depression?.BMC Med. 2016; 14: 9
- Antidepressant use, depressive symptoms, and incident frailty in women aged 65 and older from the women's health initiative observational study.J Am Geriatr Soc. 2012; 60: 854-861
- The structure of subjective well-being: A vector autoregressive approach.Metroeconomica. 2013; 64: 361-400
- Back to baseline in Britain: Adaptation in the British household panel survey.Economica. 2013; 80: 496-512
- Is frailty a prognostic factor for adverse outcomes in older patients with acute coronary syndrome?.Aging Clin Exp Res. 2020; 32: 1435-1442
- Frailty measurement in research and clinical practice: A review.Eur J Intern Med. 2016; 31: 3-10
- Operationalizing a frailty index from a standardized comprehensive geriatric assessment.J Am Geriatr Soc. 2004; 52: 1929-1933
- Risk factors for incident mild cognitive impairment–results from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe).Acta Psychiatr Scand. 2010; 121: 260-272
- Longitudinal predictors of informal and formal caregiving time in community-dwelling dementia patients.Soc Psychiatry Psychiatr Epidemiol. 2016; 51: 607-616
Article info
Publication history
Published online: November 19, 2020
Footnotes
S.G.R.-H. and H.-H.K. contributed equally to this work.
Funding Sources: This publication is part of the German Research Network on Dementia (KND), the German Research Network on Degenerative Dementia (KNDD; German Study on Ageing, Cognition and Dementia in Primary Care Patients; AgeCoDe), and the Health Service Research Initiative (Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+; AgeQualiDe)) and was funded by the German Federal Ministry of Education and Research (grants KND: 01GI0102, 01GI0420, 01GI0422, 01GI0423, 01GI0429, 01GI0431, 01GI0433, 01GI0434; grants KNDD: 01GI0710, 01GI0711, 01GI0712, 01GI0713, 01GI0714, 01GI0715, 01GI0716; grants Health Service Research Initiative: 01GY1322A, 01GY1322B, 01GY1322C, 01GY1322D, 01GY1322E, 01GY1322F, 01GY1322G). The publication was also supported by the study “Healthy Aging: Gender specific trajectories into latest life” (AgeDifferent.De) that was funded by the German Federal Ministry of Education and Research (grants 01GL1714A; 01GL1714B; 01GL1714C; 01GL1714D).
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
