Frailty, depression risk, and 10-year mortality in older adults: the FRADEA study

Abstract Objectives: To investigate if depression risk modifies the association between frailty and mortality in older adults. Design: Ongoing cohort study. Setting: Albacete city, Spain Participants: Eight hundred subjects, 58.8% women, over 70 years of age from the Frailty and Dependence in Albacete (FRADEA) study. Measurements: Frailty phenotype, Geriatric Depression Scale (GDS), comorbidity, disability, and drug use were collected at baseline. Six groups were categorized: (G1: non-frail/no depression risk; G2: non-frail/depression risk; G3: prefrail/no depression risk; G4: prefrail/depression risk; G5: frail/no depression risk; and G6: frail/depression risk). Mean follow-up was 2542 days (SD 1006). GDS was also analyzed as a continuous variable. The association between frailty and depression risk with 10-year mortality was analyzed. Results: Mean age was 78.5 years. Non-frail was 24.5%, prefrail 56.3%, frail 19.3%, and 33.5% at depression risk. Mean GDS score was 3.7 (SD 3.2), increasing with the number of frailty criteria (p < 0.001). Ten-year mortality rate was 44.9%. Mortality was 21.4% for the non-frail, 45.6% for the prefrail, and 72.7% for the frail participants, 56% for those with depression risk, and 39.3% for those without depression risk. Mean survival times for groups G1 to G6 were, respectively, 3390, 3437, 2897, 2554, 1887, and 1931 days. Adjusted mortality risk was higher for groups G3 (HR 2.1; 95% confidence interval (CI) 1.4–3.1), G4 (HR 2.5; 95% CI 1.7–3.8), G5 (HR 3.8; 95% CI 2.4–6.1), and G6 (HR 4.0; 95% CI 2.6–6.2), compared with G1 (p < 0.001). Interaction was found between frailty and depression risk, although they were independently associated with mortality. Conclusions: Depression risk increases mortality risk in prefrail older adults but not in non-frail and frail ones. Depression should be monitored in these older adults to optimize health outcomes. Factors modulating the relationship between frailty and depression should be explored in future studies.

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IS POOR QUALITY SLEEP PRESENT IN OLDER ADULTS WITH WORSE SOCIAL AND HEALTH STATUS?

Texto & Contexto - Enfermagem ◽

10.1590/1980-265x-tce-2020-0614 ◽

2021 ◽

Vol 30 ◽

Author(s):

Sonia Gonçalves da Mota ◽

Isabela Thaís Machado de Jesus ◽

Keika Inouye ◽

Marcela Naiara Graciani Fumagale Macedo ◽

Tábatta Renata Pereira de Brito ◽

...

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Sleep Disorders ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Poor Quality ◽

Frailty Phenotype ◽

Cross Sectional ◽

Significance Level ◽

Quality Sleep

ABSTRACT Objective: to analyze the relationship among sleep and sociodemographic aspects, health, frailty, performance in activities of daily living, cognitive performance and depressive symptoms of older residents in the community. Method: a cross-sectional, quantitative study was conducted with 81 older adults residents in the area covered by a Family Health Unit in the city of São Carlos (SP), Brazil. Data collection occurred in 2019, through the application of the following instruments: questionnaire for socioeconomic and health characterization of the older adult, Pittsburgh Sleep Quality Index, Frailty Phenotype proposed by Linda Fried, Mini Mental State Examination, Geriatric Depression Scale, Katz Index and Lawton Scale. Participants were divided into comparative groups according to sleep quality scores. Fisher's exact and Pearson's χ2 were used. A significance level of 5% was adopted. Results: 50.6% of the older adults had poor quality sleep (n=41), followed by 33.3% of older adults with good quality sleep (n=27) and 16.1% had sleep disorders (n=13). There was a relationship between sleep quality and sex (p=0.008), work status (p=0.001), self-assessment of health (p=0.013), falls (p=0.034), pain (p=0.012), frailty level (p=0.026) and the slow gait criterion (p<0.001). Conclusion: there was a higher prevalence of poor quality sleep and sleep disorders in older patients, who do not work outside the home, who evaluated their health as regular or poor, who suffered falls in the last year and who complained of pain, frailty and slow gait.

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Relationship Between Frailty and Depression Among Community-Dwelling Older Adults: The Mediating and Moderating Role of Social Support

The Gerontologist ◽

10.1093/geront/gnaa072 ◽

2020 ◽

Vol 60 (8) ◽

pp. 1466-1475 ◽

Cited By ~ 1

Author(s):

Yaru Jin ◽

Huaxin Si ◽

Xiaoxia Qiao ◽

Xiaoyu Tian ◽

Xinyi Liu ◽

...

Keyword(s):

Social Support ◽

Older Adults ◽

Depressive Symptoms ◽

Rating Scale ◽

Depression Scale ◽

Community Dwelling ◽

Linear Regression Models ◽

Frailty Phenotype ◽

Community Dwelling Older Adults ◽

The Relationship

Abstract Background and Objectives Frailty is associated with depression in older adults and reduces their social support. However, the mechanism underlying such relationship remains unclear. We aim to examine whether social support acts as a mediator or moderator in the relationship between frailty and depression. Research Design and Methods This cross-sectional study was conducted among 1,779 community-dwelling older adults aged 60 and older. Frailty, social support, and depressive symptoms were measured by the Physical Frailty Phenotype, Social Support Rating Scale, and five-item Geriatric Depression Scale, respectively. Data were also collected on age, gender, years of schooling, monthly income, cognitive function, number of chronic diseases, physical function, and pain. Results Linear regression models showed that subjective support and support utilization, but not objective support, mediated and moderated the relationship between frailty and depressive symptoms. The Johnson–Neyman technique determined a threshold of 30 for subjective support, but not for support utilization, beyond which the detrimental effect of frailty on depressive symptoms was offset. Discussion and Implications Social support underlies the association of frailty with depression, and its protective role varies by type. Interventions on depression should address improving perceptions and utilization of social support among frail older adults rather than simply providing them with objective support.

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Determinants of Suicidal Ideation among Older Adults

GeroPsych ◽

10.1024/1662-9647/a000250 ◽

2020 ◽

pp. 1-9

Author(s):

Mahshid Foroughan ◽

Mohammad Rostami ◽

Seyed Jalal Younesi

Keyword(s):

Older Adults ◽

Life Satisfaction ◽

Suicidal Ideation ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Cross Sectional Study ◽

Cross Sectional ◽

Satisfaction Index ◽

Relationship Of ◽

The Relationship

Abstract. This study examined the relationship of depression and life satisfaction with suicidal ideation among older Iranian adults. In this cross-sectional study, a total of 159 older adults in Tehran (73% community-residing, 60 years or older) participated. The data were gathered using the Beck Scale for Suicidal Ideation (BSSI), the Geriatric Depression Scale (GDS), and the Life Satisfaction Index-Z (LSIZ). According to the results, depression and life satisfaction are significantly related to suicidal ideation; the two variables predict 0.39% of the variance of suicidal ideation in older adults ( p < .01). The interaction between depression and life satisfaction is a stronger predictor of suicidal ideation in older adults than each of the variables alone.

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Cognitive deficits in older adults with mild cognitive impairment in a two-year follow-up study

Dementia & Neuropsychologia ◽

10.1590/1980-57642018dn12-010003 ◽

2018 ◽

Vol 12 (1) ◽

pp. 19-27 ◽

Cited By ~ 2

Author(s):

Camila de Assis Faria ◽

Heloisa Veiga Dias Alves ◽

Eduarda Naidel Barboza e Barbosa ◽

Helenice Charchat-Fichman

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Public Hospital ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Elderly Adults ◽

Geriatric Depression ◽

Neuropsychological Battery ◽

Memory Decline

ABSTRACT Characterizing cognitive decline in older adults with MCI over time is important to identify the cognitive profile of those who convert to dementia. Objective: This study examined the two-year cognitive trajectory of elderly adults diagnosed with MCI, from geriatrics and neurology outpatient clinics of a public hospital in Rio de Janeiro. Methods: 62 older adults with MCI were submitted to a neuropsychological battery and re-evaluated after two years. The Mann-Whitney U test was employed to assess differences between groups with respect to education, functioning, the Geriatric Depression Scale and diagnosis. Results: 24.2% converted to dementia after two years. The group with declines in two or more cognitive functions had a higher conversion rate to dementia than the group with decline in executive functions (EF) only (Z = -2.11, p = .04). The EF decline group had higher scores on the depression scale than both the memory decline group (Z = -1.99, p = .05) and multiple decline group (Z = -2.23, p = .03). Conclusion: The present study found different cognitive decline profiles in elderly adults with MCI and differences between them regarding depressive symptoms and rate of conversion to dementia.

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A - 17 Fear of Falling in Older Adults with mTBI

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab035.17 ◽

2021 ◽

Vol 36 (4) ◽

pp. 657-657

Author(s):

Manderino LM ◽

Kissinger-Knox A ◽

Colorito A ◽

Mucha A ◽

Puskar A ◽

...

Keyword(s):

Older Adults ◽

Fear Of Falling ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Assessment Tools ◽

Symptom Scale ◽

Post Injury ◽

Fall Efficacy Scale ◽

History Of ◽

The Relationship

Abstract Objective To evaluate the use of an assessment of fear of falling (i.e., Short Fall Efficacy Scale [SFES]) in the evaluation and management of mild traumatic brain injury (mTBI) in older adults. Methods Fifty-two older adults (40% male) aged 60–76 (66.44 ± 4.74) years were included in the study; 27 older adults diagnosed with mTBI within three months of injury (33.07 ± 18.86 days) and 25 age-group and sex-matched controls. All participants completed the SFES, Vestibular/Ocular-Motor Screening (VOMS), Post-Concussion Symptom Scale (PCSS), Generalized Anxiety Disorder- 7 Item (GAD-7), and Geriatric Depression Scale- 5 Item (GDS5). Statistical comparisons were performed using paired t-tests and Pearson correlations. Results There were no significant differences on demographic factors, with the exception of participants in the mTBI group being more likely to have a history of a sleep disorder (χ2 = 10.26, p = 0.001). T-tests revealed higher concern for falling on SFES and higher total symptoms on the VOMS, GAD-7, and PCSS (p < 0.01) in mTBI versus controls. Those with mTBI who sustained a fall, compared to other mechanisms of injury, did not differ in their report of fear of falling post-injury (p = 0.74). SFES scores were moderately correlated with VOMS total score (r = 0.40, p < 0.01), PCSS total score (r = 0.64, p < 0.01), GAD-7 (r = 0.65, p < 0.01), and GDS-5 (r = 0.60, p < 0.05). Conclusions Older adults with mTBI endorse greater fear of falling on the SFES and more symptoms on mTBI assessment tools relative to healthy controls. Future studies should include objective measures of balance to evaluate the relationship between fear of falling and postural stability.

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Changes in frailty conditions and phenotype components in elderly after hospitalization

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.1417.2905 ◽

2017 ◽

Vol 25 (0) ◽

Cited By ~ 3

Author(s):

Gianna Fiori Marchiori ◽

Darlene Mara dos Santos Tavares

Keyword(s):

Older Adults ◽

Multinomial Logistic Regression ◽

Short Form ◽

Descriptive Analysis ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Geriatric Depression ◽

Multinomial Logistic Regression Model ◽

Frailty Phenotype ◽

Predictive Variables

ABSTRACT Objective: describing the changes in frailty conditions over the period of a year after hospital discharge, verifying predictive variables for changes in frailty conditions and frailty phenotype components according to worsening, improving and stable groups. Method: a longitudinal survey carried out with 129 elderly. A structured form for socioeconomic and health data, scales (Geriatric Depression Scale - short form, Katz scale, Lawton and Brody scale) and frailty phenotype according to Fried were used. Descriptive analysis and multinomial logistic regression model (p<0.05) were performed. Results: we found that 56.7% of older adults changed their condition from non-frail to pre-frail, with no changes from non-frail to frail. Deaths were found between frail and pre-frail elderly. In the worsening group, the increase in the number of morbidities was a predictor for exhaustion and/or fatigue, while in the improving group, increased dependence on instrumental activities of daily living was a predictor for weight loss, and reduced scores indicative of depression due to low level of physical activity. Conclusion: a greater percentage of changes from non-frail condition to pre-frail older adults were observed, and health variables were only predictive for frailty phenotype components.

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

International Psychogeriatrics ◽

10.1017/s104161021800100x ◽

2018 ◽

Vol 31 (3) ◽

pp. 425-434 ◽

Cited By ~ 4

Author(s):

Ivan Aprahamian ◽

Claudia Kimie Suemoto ◽

Sumika Mori Lin ◽

Alaise Silva Santos de Siqueira ◽

Marina Maria Biella ◽

...

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Health Status ◽

Outpatient Clinic ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Estimating Equation ◽

Antidepressant Use ◽

A Prospective Study

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.

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Effect of Frequency of Exercise on Cognitive Function in Older Adults: Serial Mediation of Depression and Quality of Sleep

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17030709 ◽

2020 ◽

Vol 17 (3) ◽

pp. 709 ◽

Cited By ~ 4

Author(s):

Manqiong Yuan ◽

Hanhan Fu ◽

Ruoyun Liu ◽

Ya Fang

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Protective Factor ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Quality Of Sleep ◽

Mediation Analyses ◽

Face To Face ◽

The Relationship

Background: Sleep quality and depression are two reciprocal causation socioemotional factors and their roles in the relationship between physical exercise and cognition are still unclear. Methods: A face-to-face survey of 3230 older adults aged 60+ was conducted in Xiamen, China, in 2016. Frequency of exercise (FOE) referred to the number of days of exercise per week. Quality of sleep (QOS) was categorized into five levels: very poor/poor/fair/good/excellent. The 15-item Geriatric Depression Scale (GDS-15) and the Montreal Cognitive Assessment (MoCA) were used to measure depression (DEP) and cognitive function (CF), respectively. Serial multiple mediator models were used. All mediation analyses were analyzed using the SPSS PROCESS macro. Results: 2469 respondents had valid data with mean scores for GDS-15 and MoCA being 1.87 and 21.61, respectively. The direct path from FOE to CF was significant (c’= 0.20, p < 0.001). A higher FOE was associated with better QOS (B = 0.04, p < 0.01), which in turn was associated with fewer symptoms of DEP (B = −0.40, p < 0.001), and further contributed to better CF (B = −0.24, p < 0.001). Similarly, a higher FOE was associated with lower GDS-15 scores (B = −0.17, p < 0.001) which then resulted in higher MoCA scores (B = −0.24, p < 0.001). However, QOS alone did not alter the relationship between FOE and CF. Conclusions: FOE is a protective factor of CF in older adults. Moreover, CF is influenced by QOS through DEP, without which the working path may disappear.

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A-63 The Fatigue Severity Scale and Depression in an Aging Population

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz034.63 ◽

2019 ◽

Vol 34 (6) ◽

pp. 923-923

Author(s):

N Kaplan ◽

M Leavitt ◽

J Miller

Keyword(s):

Older Adults ◽

Geriatric Depression Scale ◽

Memory Loss ◽

Depression Scale ◽

Cognitive Disorders ◽

Fatigue Severity Scale ◽

Common Symptom ◽

Severity Scale ◽

Fatigue Severity ◽

The Relationship

Abstract Objective The Fatigue Severity Scale (FSS) is often used in clinical populations in which fatigue is a common symptom (e.g., multiple sclerosis). Despite the prevalence of fatigue in depression, relatively few investigations have examined the relationship between the FSS and mood symptoms, particularly in aging populations with concerns of memory loss. Thus, the primary aim of the present investigation was to elucidate the relationship between fatigue symptoms and depression among older adults evaluated in a cognitive disorders clinic. Method Data were collected as part of a neuropsychological battery administered to patients presenting to clinic due to complaints of memory impairment. Scores on the FSS and the Geriatric Depression Scale (GDS) were collected from 430 patients (48.10% women). Mean age was 74.97 years (SD = 5.81) and 147 subjects were diagnosed with depression, based on a score of 10 or above on the GDS. Results We observed a small, but significant inverse relationship between age and scores on the FSS [r = -.103, p = .033], such that older adults endorsed less severe fatigue. A moderate, positive relationship between FSS and GDS was observed [r = .416, p = .000]. Comparing FSS endorsement between depressed and non-depressed individuals finds individuals with depression endorsed significantly greater levels of fatigue than non-depressed individuals, even after accounting for the effects of age [F(1, 427) = 85.79. p < .001; Cohen's d = 0.96]. Conclusion Present findings suggest that older adults do not necessarily endorse higher rates of fatigue on the FSS. However, the presence of depression in older adults has large effects on fatigue severity.

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The Relationship between Depression and Fear of Falling in Older Adults Referred to Rasht Comprehensive Health Centers

Jundishapur Journal of Chronic Disease Care ◽

10.5812/jjcdc.101944 ◽

2020 ◽

Vol 9 (3) ◽

Author(s):

Atefeh Basharkhah ◽

Mohammad Esmaeilpour-Bandboni ◽

Abdolhosein Emami Sigaroudi

Keyword(s):

Older Adults ◽

Fear Of Falling ◽

Common Mental Disorder ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Health Centers ◽

P Value ◽

Comprehensive Health ◽

The Mean ◽

The Relationship

Background: Increased life expectancy has increased the likelihood of chronic diseases. Depression, as the most common mental disorder for older adults, and fear of falling, which may lead to lower self-esteem and self-efficacy, can be barriers to proper physical activity. Objectives: The current study aimed to determine the relationship between depression and fear of falling in older adults. Methods: This descriptive-correlational study was conducted in 2018 on 90 randomly selected older adults aged 60 years and older referred to comprehensive health centers in the city of Rasht. Data were collected using a questionnaire on demographic information, a 15-item Geriatric Depression scale, and Falls Efficacy Scale-International Form. Data were analyzed through SPSS version 21 using descriptive and inferential tests (the Spearman and the Mann-Whitney U correlation coefficient). A P value of < 0.005 was considered as statistically significant. Results: Most of the participants (60%) were female. The mean age was 68.44 ± 7.60 years, the mean depression score was 7.40 ± 2.03, and the mean fear of falling was 36.97 ± 12.73. There was a significant positive correlation between depression and fear of falling (r = 0.420, P = 0.0001). Conclusions: These findings clarify the importance of proper planning by health authorities to prevent and treat mental disorders in older adults.

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