Depressive symptoms and frailty

作者：St John Philip D^*; Tyas Suzanne L; Montgomery Patrick R

来源：International Journal of Geriatric Psychiatry, 2013, 28(6): 607-614.

DOI：10.1002/gps.3866

• frailty
• accumulation of deficits
• depression
• depressive symptoms
• CES-D

Background Frailty and depressive symptoms are common issues facing older adults and may be associated. Objectives To determine if: (i) depressive symptoms are associated with frailty; (ii) there is a gradient in this effect across the range of depressive symptoms; and (iii) the association between depressive symptoms and frailty is specific to particular types of depressive symptoms (positive affect, negative affect, somatic complaints, and interpersonal relations). Method Secondary analysis of an existing population-based study was conducted. Population In 1991, 1751 community-living adults aged 65+years were interviewed. Measures Depressive symptoms were measured using the Center for Epidemiologic StudiesDepression (CES-D) scale. Frailty was graded from 0 (no frailty) to 3 (moderate/severe frailty). Age, gender, education, marital status, self-rated health, and the number of comorbid conditions were self-reported. Analyses Logistic regression models were constructed with the outcome of no frailty/urinary incontinence only versus frailty. Results Depressive symptoms were strongly associated with frailty, and there was a gradient effect across the entire range of the CES-D scale. The odds ratio and 95% confidence interval was 1.08 (1.06, 1.09) per point of the CES-D in unadjusted models. After potential confounding factors were adjusted, the adjusted odds ratio (95% confidence interval) was 1.03 (1.01, 1.05). Positive affect, negative affect, and somatic complaints were all associated with frailty, whereas interpersonal relations were not associated with frailty. Conclusions Depressive symptoms are associated with frailty. Clinicians should consider assessing frail older adults for the presence of depression.

• 出版日期2013-6