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Psychiatric Illness in Relation to Frailty in Community-Dwelling Elderly People without Dementia: A Report from the Canadian Study of Health and Aging*

Published online by Cambridge University Press:  31 March 2010

Melissa K. Andrew  and
Kenneth Rockwood
Melissa K. Andrew
Affiliation:
Division of Geriatric Medicine, Dalhousie University
Kenneth Rockwood*
Affiliation:
Division of Geriatric Medicine, Dalhousie University
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à: Kenneth Rockwood, Centre for Health Care of the Elderly, Camp Hill Veterans' Memorial Building, 1421–5955 Jubilee Road, Halifax, NS B3H 2E1. ([email protected])
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Abstract

We investigated whether frailty, defined as the accumulation of multiple, interacting illnesses, impairments and disabilities, is associated with psychiatric illness in older adults. Five-thousand-six-hundred-and-seventy-six community dwellers without dementia were identified within the Canadian Study of Health and Aging, and self-reported psychiatric illness was compared by levels of frailty (defined by an index of deficits that excluded mental illnesses). People with psychiatric illness (12.6% of those surveyed, who chiefly reported depression) had a higher mean frailty index value than those who did not. Older age was not associated with higher odds of psychiatric illness. Taking sex, frailty, and education into account, the odds of psychiatric illness decreased with each increasing year of age (OR 0.95; 95% CI, 0.94–0.97). Frailty was associated with psychiatric illness; for each additional deficit-defining frailty, odds of psychiatric illness increased (OR 1.23; 95% CI, 1.19–1.26). Similarly, psychiatric illness was associated with much higher odds of being among the most frail. These findings lend support to a multidimensional conceptualization of frailty. Our data also suggest that health care professionals who work with older adults with psychiatric illness should expect frailty to be common, and that those working with frail seniors should consider the possible co-existence of depression and psychiatric illness.

Résumé

Le but de notre enquête était de déterminer si la fragilité (défini comme l'accumulation de maladies, infirmités, et troubles multiples) est associée avec la morbidité psychiatrique chez les adultes âgés vivants à leur propre domicile. On a identifié 5676 personnes âgées sans démence dans L'Étude sur la santé et le vieillissement au Canada, et la relation entre la morbidité psychiatrique auto-signalée et la fragilité (défini comme un index de déficits à l'exclusion de la morbidité psychiatrique) a été examinée. Les sujets avec la morbidité psychiatrique (dont 12,6 % de l'échantillon, la grande majorité ayant la dépression), avaient une valeur moyenne de fragilité selon l'index supérieure à celle des sujets sans une morbidité psychiatrique. Il y avait une association importante entre la fragilité et la morbidité psychiatrique : avec chaque déficit comprenant l'index, la probabilité d'avoir une morbidité psychiatrique s'est augmenté (OR 1,23; 95 % CI, 1,19-1,26). Ceux qui avaient la morbidité psychiatrique avaient également une probabilité beaucoup plus haute de se trouver parmi les plus fragiles. Nos résultats appuyent une conceptualisation multidimensionnelle de la fragilité, et suggèrent que les professionnels dans le domaine de la santé travaillant avec les adultes âgés ayant morbidité psychiatrique doivent s'attendre à ce que la fragilité soit répandue.

Keywords

agingCanadian Study of Health and Aging (CSHA)frailtydepressionpsychiatric illnessolder adultsvieillissementl'étude sur la santé et le vieillissement au Canadafragilitédepressionmorbidité psychiatriqueadultes âgés
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 26 , Issue 1 , Spring/Printemps 2007 , pp. 33 - 38
Copyright
Copyright © Canadian Association on Gerontology 2007

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Footnotes

*

The data reported in this article were collected as part of the Canadian Study of Health and Aging. The core study was funded by the Seniors' Independence Research Program, through the National Health Research and Development Program of Health Canada (Project No. 6606-3954-MC[S]). The study was coordinated through the University of Ottawa and the Division of Aging and Seniors, Health Canada. Melissa Andrew was supported by a Ross Stewart Smith Fellowship and a Dalhousie University Internal Medicine Research Foundation Research Fellowship. Kenneth Rockwood receives support from the Canadian Institutes for Health Research through an Investigator award and from the Dalhousie Medical Research Foundation as Kathryn Allen Weldon Professor of Alzheimer Research. The authors declare that they have no competing interests.

This article was presented at the International Psychogeriatric Association's 12th International Congress, Stockholm, September 2005.

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