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Is frailty a predictor of mortality in late-life depression?

Published online by Cambridge University Press:  01 September 2022

M. Arts*
Affiliation:
GGZWNB, Psychiatry, Halsteren, Netherlands

Abstract

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Introduction

Frailty is a clinical phenotype that predicts negative health outcomes including mortality. Similar to frailty, late-life depression is also associated with increased mortality rates.

Objectives

Our objective was to examine whether frailty and frailty related biomarkers predict mortality among depressed older patients.

Methods

Among 378 older patients (≥60 years) with a depressive disorder (DSM-IV criteria) we examined whether frailty predicts time-to-death during a six-year follow-up using Cox-regression analyses adjusted for confounders. Baseline data were collected between 2007 and September 2010. Frailty was defined according to Fried’s criteria (muscle weakness, slowness, exhaustion, low activity level, unintended weight loss). Similarly, we examined the predictive value of three inflammatory markers, vitamin D level, and leucocyte telomere length, and whether these effects were independent of the frailty phenotype.

Results

During follow-up, 26.2% frail depressed patients died compared to 12.7% non-frail depressed patients (p<.001). Adjusted for confounders, the number of frailty components was associated with an increased mortality rate (HR=1.38 [95%CI: 1.06–1.78], p=.015). All biomarkers were prospectively associated with mortality, but only higher levels of hsCRP and lower levels of vitamin D were independent of frailty associated with mortality.

Conclusions

Frailty identifies older patients at increased risk of adverse negative health outcomes in late-life depression. Therefore, among frail-depressed patients, treatment models that include frailty-specific interventions might reduce mortality rates.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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