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. 2020 Feb;28(2):145-154.
doi: 10.1016/j.jagp.2019.10.005. Epub 2019 Oct 14.

Frailty and Its Correlates in Adults With Late Life Depression

Patrick J Brown  1 , Steven P Roose  1 , Kaleigh R O'Boyle  1 , Adam Ciarleglio  2 , Benjamin Maas  3 , Kay C Igwe  3 , Sarah Chung  4 , Stephanie Gomez  1 , Maleeha Naqvi  1 , Adam M Brickman  3 , Bret R Rutherford  1
Affiliations

Frailty and Its Correlates in Adults With Late Life Depression

Patrick J Brown et al. Am J Geriatr Psychiatry. 2020 Feb.

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.

Keywords: Frailty; biological aging; late life depression; vascular depression.

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Figures

Figure 1.
Figure 1.. Breakdown of frailty burden in adults with late life depression.
Note. The figure displays the number of frailty characteristics and the prevalence of that level of frailty burden that was observed in this sample of adults with LLD using both the cut scores for the Fried Frailty phenotype as well as for clinically significant frailty which utilizes different cut scores for gait speed (< 1 m/s) and physical activity levels (< 1000 kcal/week).
Figure 2.
Figure 2.. Prevalence of physical frailty deficits including slow gait speed and weak grip strength in adults with late life depression.
Note. The figure displays the manifestations of frailty based on the presence or absence of the physical characteristics of frailty burden observed in this sample of adults with LLD. Two cut scores were used for the definition of slow gait: the Fried Frailty definition which utilizes cut score of < .8 m/s and a clinically significant cut score which utilizes a gait speed of < 1 m/s.
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