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

2018 ◽  
Vol 31 (3) ◽  
pp. 425-434 ◽  
Author(s):  
Ivan Aprahamian ◽  
Claudia Kimie Suemoto ◽  
Sumika Mori Lin ◽  
Alaise Silva Santos de Siqueira ◽  
Marina Maria Biella ◽  
...  

ABSTRACTObjectives:The aim of the present study was to evaluate the association between depression and SSRI monotherapy and frailty both baseline and prospectively in older adults.Design:Prospective cohort study, 12-month follow-up.Setting:Geriatric outpatient clinic in São Paulo, Brazil.Participants:A total of 811 elderly adults aged 60 or older.Measurements:Depression was diagnosed as follows: (1) a diagnosis of major depression disorder (MDD) according to DSM-5; or (2) an incomplete diagnosis of MDD, referred to as minor or subsyndromic depression, plus Geriatric Depression Scale 15-itens ≥ 6 points, and social or functional impairment secondary to depressive symptoms and observed by relatives. Frailty evaluation was performed through the FRAIL questionnaire, which is a self-rated scale. Trained investigators blinded to the baseline assessment conducted telephone calls to evaluate frailty after 12-month follow-up. The association between depression and the use of SSRI with frailty was estimated through a generalized estimating equation adjusted for age, gender, total drugs, and number of comorbidities.Results:Depression with SSRI use was associated with frailty at baseline (OR 2.82, 95% CI = 1.69–4.69) and after 12 months (OR 2.75, 95% CI = 1.84–4.11). Additionally, depression with SSRI monotherapy was also associated with FRAIL subdomains Physical Performance (OR 1.99, 95% CI = 1.29–3.07) and Health Status (OR 4.64, 95% CI = 2.11–10.21). SSRI use, without significant depressive symptoms, was associated with subdomain Health Status (OR 1.52, 95% CI = 1.04–2.23).Conclusion:It appears that depression with SSRI is associated to frailty, and this association cannot be explained only by antidepressant use.

2021 ◽  
Author(s):  
Jialin Liu ◽  
Zixuan Chen ◽  
Yuke Yu ◽  
Qin Wang ◽  
Xiuxiu Liu ◽  
...  

Abstract Objective: This study aimed to analyze the effects of chronic pain on the occurrence of depressive symptoms in Chinese middle-aged and older adults, and to provide a scientific basis for reducing the incidence of depressive symptoms, improving the quality of life in middle-aged and older adults, and reducing the disease burden in the aging population.Methods: a prospective study was conducted to select adults aged 45 years or older from the longitudinal study of China Health and elderly care follow-up survey (Charls) (2015 and 2018). Pain was assessed according to the patient's self exposure, and depression was assessed using the Chinese version of the center for epidemiological research Depression Scale (CES-D). Univariate analysis and binary logistic regression model were used for analysis. Results: The 3-year cumulative incidence of depression in chronic pain patients was 52.4% and the annual incidence was 17.5% in the middle-aged and elderly Chinese population. Univariate analysis showed statistically significant differences in the incidence of depressive symptoms between the different genders, age, residence, education level, marriage, self perceived health status, nocturnal sleep time, number of social activities in the past month, smoking, alcohol consumption, impaired ADL and Medicare insurance coverage. This study, after controlling for demographic characteristics, health status and health behaviors, Different pain conditions remained statistically significant for depression in middle-aged and older adults. Compared with middle-aged and older adults without pain, both Unisomatic pain (OR = 1.388) and Multiple somatic pain (OR= 1.869) increased the risk of depression in the middle-aged and older populations. Conclusion: chronic pain is associated with the risk of depressive symptoms in middle-aged and elderly people, and the incidence of depression in middle-aged and elderly people in China is not optimistic.


2020 ◽  
Vol 76 (1) ◽  
pp. 151-156 ◽  
Author(s):  
Laurel Cherian ◽  
Yamin Wang ◽  
Thomas Holland ◽  
Puja Agarwal ◽  
Neelum Aggarwal ◽  
...  

Abstract Background Depression is common in older adults and more prevalent in those with cognitive impairment, vascular risk factors, or stroke. Nonpharmacologic strategies to reduce depression, such as diet, may be effective; however, few studies have investigated the relation. Methods A total of 709 participants (23.3% men, mean age 80.4), from an observational prospective cohort study were assessed annually for an average of 6.53 years of follow-up. Participants with missing or invalid baseline dietary evaluations or fewer than two depression assessments were excluded. Depressive symptoms were assessed with a 10-item version of the Center for Epidemiologic Studies Depression scale. High burden of depressive symptoms was defined as the presence of four or more depressive symptoms. Diet scores were computed using a validated food frequency questionnaire for the Dietary Approaches to Stop Hypertension (DASH) diet, Mediterranean diet, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, and Western diets. Diet scores were modeled in tertiles. A generalized estimating equation (GEE) model was performed for the longitudinal analysis of depression as a binary outcome. Results Participants in the highest tertile of the DASH (β = −0.10, confidence interval [CI]: −0.20, −0.0064) and MIND (β = −0.12, CI: −0.23, −0.0092) diet scores had lower rates of depressive symptoms over time when compared to those in the respective lowest tertiles. The Western diet was positively associated with depressive symptoms over time (β = 0.093, p-trend = .05). Conclusions Diet may be effective in reducing depressive symptoms in older adults. A diet intervention trial may be needed to determine the optimal nutritional components for prevention of late onset depression.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 788-788
Author(s):  
Milan Chang ◽  
Hrafnhildur Eymundsdottir ◽  
Alfons Ramel ◽  
Sigurveig Sigurdardottir ◽  
Vilmundur Gudnasson ◽  
...  

Abstract Background Depressive symptoms in older adults are associated with socioeconomic status (SES), medical care, and physical activity. However, there is little evidence on the longitudinal association between level of leisure activity (LA) and physical activity (PA) with depressive symptoms among community-dwelling older adults in Iceland. The study examined an association of LA and PA at baseline with high depressive symptoms (HGDS) assessed after 5 years of follow-up among community-dwelling older adults. Methods A large community-based population residing in Reykjavik, Iceland participated in a longitudinal study with 5 years of follow-up (n=2957, 58% women, 74.9±4.8 yrs). Those with HGDS or dementia at baseline were excluded from the analysis. The reported activity was categorized into 2 groups as no-activity versus any-activity. Depressive symptoms were assessed by the 15-item Geriatric Depression Scale (GDS) on average 5 years later. Results After adjusting for demographic and health-related risk factors, those who reported having any LA had significantly fewer HGDS after the follow-up of 5 years (6 or higher GDS scores, Odds Ratio (OR) = 0.46, 95% Confidence Interval (CI): 0.27 ~ 0.76, P = 0.003). However, reporting any PA at baseline was not significantly associated with HGDS (OR = 0.71, 95% CI: 0.51 ~ 1.00, P = 0.053). Conclusion Our study shows that any LA among older adults is associated with having less depressive symptoms 5 years later among community-dwelling older adults while having any PA was not associated with depressive symptoms after 5 years of follow-up.


2019 ◽  
Vol 32 (2) ◽  
pp. 97-103 ◽  
Author(s):  
Ali Ezzati ◽  
Mindy J. Katz ◽  
Carol A. Derby ◽  
Molly E. Zimmerman ◽  
Richard B. Lipton

Background: There is increasing evidence that depressive symptoms are associated with increased risk of cognitive impairment and dementia in older adults. In current study, we aimed to investigate the effect of depressive symptoms on incident Alzheimer disease and all-cause dementia in a community sample of older adults. Methods: Participants were 1219 older adults from the Einstein Aging Study, a longitudinal cohort study of community-dwelling older adults in Bronx County, New York. The Geriatric Depression Scale (GDS, 15-item) was used as a measure of depressive symptoms. The primary outcome was incident dementia diagnosed using the Diagnostic and Statistical Manual, Fourth Edition, criteria. Cox proportional hazard models were used to estimate the risk of incident dementia as a function of GDS score for the whole population and also for 2 different time intervals, <3 years and ≥3 years after baseline assessment. Results: Among participants, 132 individuals developed dementia over an average 4.5 years (standard deviation [SD] = 3.5) of follow-up. Participants had an average age of 78.3 (SD = 5.4) at baseline, and 62% were women. Among all participants, after controlling for demographic variables and medical comorbidities, a 1-point increase in GDS was associated with higher incidence of dementia (hazard ratio [HR] = 1.11, P = .007). After up to 3 years of follow-up, depressive symptoms were not significantly associated with dementia incidence (HR = 1.09; P = .070). However, after more than 3 years, GDS score was a significant predictor of incident dementia (HR = 1.13, P = .028). Conclusions: Our results suggest that depressive symptoms are associated with an increased risk of incident dementia in older adults.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Taishi Tsuji ◽  
Satoru Kanamori ◽  
Ryota Watanabe ◽  
Meiko Yokoyama ◽  
Yasuhiro Miyaguni ◽  
...  

AbstractThe current study investigated the relationship between the frequency of watching sports and depressive symptoms among older adults. This study used cross-sectional data from the Japan Gerontological Evaluation Study, a nationwide mail survey of 21,317 older adults. Depressive symptoms were defined as a Geriatric Depression Scale score of ≥ 5. Participants were queried regarding the average frequency at which they watched sports on-site and via TV/Internet over the past year. Among the 21,317 participants, 4559 (21.4%) had depressive symptoms, while 4808 (22.6%) and 16,576 (77.8%) watched sports on-site and via TV/Internet at least once a year, respectively. Older adults who watched sports on-site a few times/year (prevalence ratio, 0.70; 95% confidence interval, 0.65–0.74) or 1–3 times/month (0.66, 0.53–0.82) were less likely to have depressive symptoms compared to non-spectators after adjusting for frequency of playing sports, exercise activities, and other potential confounders. Meanwhile, a dose–response relationship was confirmed for watching via TV/Internet (prevalence ratio of 0.86, 0.79, and 0.71 for a few times/year, 1–3 times/month, and ≥ 1 time/week, respectively). This study suggested that watching sports on-site or via TV/Internet, regardless of whether they regularly engage in sports, may reduce the risk of depressive symptoms among older adults.


2020 ◽  
Vol 127 (12) ◽  
pp. 1651-1662
Author(s):  
Julia Brandt ◽  
Katharina Warnke ◽  
Silke Jörgens ◽  
Volker Arolt ◽  
Katja Beer ◽  
...  

AbstractDepression and coronary heart disease (CHD) are prevalent and often co-occurring disorders. Both have been associated with a dysregulated stress system. As a central element of the stress system, the FKBP5 gene has been shown to be associated with depression. In a prospective design, this study aims to investigate the association of FKBP5 with depressive symptoms in CHD patients. N = 268 hospitalized CHD patients were included. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS-D) at four time points (baseline, and after 1 month, 6 months, and 12 months). The functional FKBP5 single-nucleotide polymorphism (SNP) rs1360780 was selected for genotyping. Linear regression models showed that a higher number of FKBP5 C alleles was associated with more depressive symptoms in CHD patients both at baseline (p = 0.015) and at 12-months follow-up (p = 0.025) after adjustment for confounders. Further analyses revealed that this effect was driven by an interaction of FKBP5 genotype with patients’ prior CHD course. Specifically, only in patients with a prior myocardial infarction or coronary revascularization, more depressive symptoms were associated with a higher number of C alleles (baseline: p = 0.046; 1-month: p = 0.026; 6-months: p = 0.028). Moreover, a higher number of C alleles was significantly related to a greater risk for dyslipidemia (p = .016). Our results point to a relevance of FKBP5 in the association of the two stress-related diseases depression and CHD.


Author(s):  
Dan Song ◽  
Doris S.F. Yu ◽  
Polly W.C. Li ◽  
Qiuhua Sun

High-level depressive symptoms have been reported in individuals with mild cognitive impairment (MCI), resulting in increased risk of progression to dementia. However, studies investigating the correlates of depressive symptoms among this population are scarce. This study aimed to investigate the significant socio-demographic, lifestyle-related and disease-related correlates of depressive symptoms among this cohort. Cross-sectional data were obtained from a sample of 154 Chinese community-dwelling older adults with MCI. MCI subjects were screened by the Montreal Cognitive Assessment. Depressive symptoms were measured by the Geriatric Depression Scale. Possible correlates of depressive symptoms in individuals with MCI were explored by multiple linear regressions. The prevalence of depressive symptoms among Chinese older adults with MCI was 31.8%. In multiple regression analysis, poor perceived positive social interaction, small social network, low level of physical activity, poor functional status, subjective memory complaint, and poor health perception were correlated with depressive symptoms. The findings highlight that depressive symptoms are sufficient to warrant evaluation and management in older adults with MCI. Addressing social isolation, assisting this vulnerable group in functional and physical activities, and cultivating a positive perception towards cognitive and physical health are highly prioritized treatment targets among individuals with MCI.


2011 ◽  
Vol 23 (6) ◽  
pp. 950-960 ◽  
Author(s):  
Kathryn Betts Adams

ABSTRACTBackground: In light of inconsistencies in cut points for identifying non-major depression, this study examined the classification efficiency of the Geriatric Depression Scale (GDS and GDS-15) total scores and individual items, and four additional depressive symptoms for identification of subthreshold, minor, or criterion depression among 166 vulnerable residents of congregate housing.Methods: Depression (combined categories of major depressive episode, minor, or subthreshold depression) was determined by the Mini-International Neuropsychiatric Interview (MINI) diagnostic interview depression module administered by telephone to 166 older residents of congregate housing facilities who also completed the 30-item GDS and four other yes/no potential indicators of geriatric depression. Classification agreement and ROC curve analysis for the full and 15-item GDS scale scores were calculated. Individual item hit rates for MINI criterion were calculated for GDS items and four new items.Results: GDS and GDS-15 at standard cut points had 70–75% agreement with MINI. Best sensitivity and specificity were obtained at lower than standard cut points. Some GDS Withdrawal, Apathy, lack of Vigor (WAV) and cognitive items obtained very low hit rates. New items “I just don't feel like myself” and “I feel I am a burden to others” better discriminated MINI depression than most GDS items and had good item-to-total correlations with the GDS.Conclusions: Diagnostic criteria and GDS screen had partial agreement. Some GDS items did not adequately represent depression among functionally impaired or oldest old older adults. Feeling one is a burden and the sense of feeling “different” from usual may be useful indicators of depression among vulnerable older adults.


2020 ◽  
Vol 9 (3) ◽  
pp. 795
Author(s):  
Michio Maruta ◽  
Hyuma Makizako ◽  
Yuriko Ikeda ◽  
Hironori Miyata ◽  
Atsushi Nakamura ◽  
...  

The aim of this cross-sectional study was to investigate relationships between individuals’ ratings of satisfaction and performance of activities that they found meaningful and depressive symptoms. Data was obtained from 806 older adults (mean age 74.9 ± 6.3 years, women = 63.0%) who participated in a community-based health check survey (Tarumizu Study 2018). Participants selected meaningful activities from 95 activities using the Aid for Decision-Making in Occupation Choice and evaluated their satisfaction and performance. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15) and defined by a GDS-15 score of ≥5. Non-linear logistic regression analyses were used separately by gender to examine the association between satisfaction and performance of meaningful activities and depressive symptoms. The prevalence of depressive symptoms was 15.8%. We found no significant difference between meaningful activity choice between older adults with depressive symptoms and those without, in both men and women. After adjusting for potential covariates, satisfaction was associated with depressive symptoms in both men (OR 0.52, 95% CI 0.35–0.77) and women (OR 0.67, 95% CI 0.49–0.91), but performance was limited in women (OR 0.87, 95% CI 0.77–0.99). Our findings suggest that depressive symptoms are associated with satisfaction in meaningful activities regardless of activity categories.


Author(s):  
Christian Oswaldo Acosta Quiroz ◽  
Raquel García-Flores ◽  
Sonia Beatriz Echeverría-Castro

The objective of this study was to evaluate the reliability and validity of the Geriatric Depression Scale in its 15-item version (GDS-15) in Mexican older adults. Participants included 1178 older adults between the ages of 60 and 94 ( M = 69.16, SD = 7.69); 53.9% were women and 55.8% were married or with a partner. They completed the GDS-15, a subjective well-being scale, and a quality-of-life questionnaire. A Kuder–Richardson coefficient of .80 was obtained, which indicates an acceptable internal consistency of the GDS-15, as well as evidence of divergent validity with significant correlations of −.783 with subjective well-being and −.569 with quality of life, in addition to concurrent validity when discriminating between participants with low scores from those with high scores of depressive symptoms. The need for a simple screening tool such as the GDS-15 that helps in the identification of depressive symptoms in Mexican older adults is underlined.


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