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Frailty and Its Correlates in Adults With Late Life Depression

Published:October 14, 2019DOI:https://doi.org/10.1016/j.jagp.2019.10.005

      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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