Highlights
- •Recent studies have shown an association between the biological syndrome of frailty and late life depression. These studies, however, were primarily epidemiological and not constructed to deconstruct the frailty-depression relationship. As such, the primary focus of this study was to investigate the rates of frailty and frailty characteristics and examine the clinical and neuropsychological correlates of frailty in adults with late life depression.
- •The main findings from this study are that frailty, specifically physical frailty deficits in mobility and strength, is highly comorbid in adults with late life depression and associated with greater depressive symptom severity. Furthermore, we saw no evidence of a relationship between frailty and the vascular depression subtype of LLD.
- •This study provides evidence that frailty, and in particular physical deficits in mobility and strength, is prevalent in adults with late life depression and may differ from known subtypes of late life depression such as vascular depression. As such, these deficits and their biological correlates may prove useful as targets for future intervention studies.
ABSTRACT
Objective
To investigate the rates of frailty and frailty characteristics and examine the clinical
and neuropsychological correlates of frailty in adults with late life depression (LLD).
Methods
Data were used from the evaluation of 134 individuals over the age of 60 years (45
men, 89 women) with a depressive diagnosis who enrolled in studies for the treatment
of their depression. Depression, neuropsychological functioning, white matter hyperintensity
(WMH) burden via magnetic resonance imaging, and characteristics of frailty were assessed.
Results
Fried frailty burden (≥3 characteristics) was present in 25% of the sample, with this
rate increasing to 45.5% when using clinically meaningful cut-scores for gait speed
(<1 m/s) and physical activity levels (<1000 kcal/week). Moreover, 62% of the sample
exhibited gait slowing (<1 m/s) or weakness (grip strength), with 29% demonstrating
both. Greater frailty burden was associated with greater Hamilton Depression Rating
Scale severity in covariate adjusted linear regression models (t127 = 2.41, p = 0.02). Greater frailty burden was not associated with neuropsychological
dysfunction, nor was it associated with greater WMH burden.
Conclusion
Findings from this study show that frailty, specifically physical frailty deficits
in mobility and strength, is highly comorbid in adults with LLD, associated with greater
depressive symptom severity, and does not appear to be associated with the vascular
depression subtype of LLD. Future research should investigate the relationship between
frailty and antidepressant treatment response as well as test whether there are age-related
biological processes that result in the manifestation of the frail-depressed subtype
of LLD.
Key Words
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Article info
Publication history
Published online: October 14, 2019
Accepted:
October 7,
2019
Received in revised form:
October 7,
2019
Received:
October 2,
2019
Identification
Copyright
© 2019 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
