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Frailty, depression, and anxiety in later life

Published online by Cambridge University Press:  14 February 2012

Aine M. Ní Mhaoláin ,
Chie Wei Fan ,
Roman Romero-Ortuno ,
Lisa Cogan ,
Clodagh Cunningham ,
Rose-Anne Kenny  and
Brian Lawlor
Aine M. Ní Mhaoláin*
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland
Chie Wei Fan
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland
Roman Romero-Ortuno
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland
Lisa Cogan
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland
Clodagh Cunningham
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland
Rose-Anne Kenny
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland Department of Medical Gerontology, Trinity College Dublin, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
Brian Lawlor
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
*
Correspondence should be addressed to: Dr Aine M. Ní Mhaoláin, TRIL Clinic, St James's Hospital, Dublin 8, Ireland. Phone: +35314164095; Fax: +35314103487. Email: ainemullen@gmail.com.
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Abstract

Background: Anxiety and depression are common in older people but are often missed; to improve detection we must focus on those elderly people at risk. Frailty is a geriatric syndrome inferring increased risk of poor outcomes. Our objective was to explore the relationship between frailty and clinically significant anxiety and depression in later life.

Methods: This study had a cross-sectional design and involved the assessment of 567 community-dwelling people aged ≥60 years recruited from the Technology Research for Independent Living (TRIL) Clinic, Dublin. Frailty was measured using the Fried biological syndrome model; depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale; and anxiety symptoms measured using the Hospital Anxiety and Depression Scale.

Results: Higher depression and anxiety scores were identified in both pre-frail and frail groups compared to robust elders (three-way factorial ANOVA, p ≤0.0001). In a logistic regression model the odds ratio for frailty showed a significantly higher likelihood of clinically meaningful depressive and anxiety symptoms even controlling for age, gender and a history of depression or anxiety requiring pharmacotherapy (OR = 4.3; 95% CI 1.5, 11.9; p = 0.005; OR = 4.36; 95% CI 1.4, 13.8; p = 0.013 respectively).

Conclusions: Our findings suggest that even at the earliest stage of pre-frailty, there is an association with increased symptoms of emotional distress; once frailty develops there is a higher likelihood of clinically significant depression and anxiety. Frailty may be relevant in identifying older people at risk of deteriorating mental health.

Keywords

frailtyanxietydepressionelderly
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Special Issue 8: Focus on late life depression , August 2012 , pp. 1265 - 1274
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Andrew, M. K. and Rockwood, K. (2007). Psychiatric illness in relation to frailty in community-dwelling elderly people without dementia: a report from the Canadian Study of Health and Aging. Canadian Journal on Aging, 26, 33–38.CrossRefGoogle ScholarPubMed
Bandeen-Roche, K. et al. (2006). Phenotype of frailty: characterization in the women's health and ageing studies. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 61A, 262–266.CrossRefGoogle Scholar
Bergman, H. et al. (2007). Frailty: an emerging research and clinical paradigm issues and controversies. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 62, 731–737.CrossRefGoogle ScholarPubMed
Bourgault-Fagnou, M. and Hadjistavropoulos, H. (2009). Understanding health anxiety among community dwelling seniors with varying degrees of frailty. Aging and Mental Health, 13, 226–237.CrossRefGoogle ScholarPubMed
Buchner, D. M., Larson, E. B., Wagner, E. H., Koepsell, T. D. and de Lateur, B. J. (1996). Evidence for a non-linear relationship between leg strength and gait speed. Age and Ageing, 25, 386–391.CrossRefGoogle ScholarPubMed
Charlson, M., Szatrowski, T., Peterson, J. and Gold, J. (1994). Validation of a combined comorbidity index. Journal of Clinical Epidemiology, 47, 1245–1251.CrossRefGoogle ScholarPubMed
Cigolle, C. T., Ofstedal, M. B., Tian, Z. and Blaum, C. S. (2009). Comparing models of frailty: the Health and Retirement Study. Journal of the American Geriatrics Society, 57, 830–839.CrossRefGoogle ScholarPubMed
de Jong-Gierveld, J. and van Tilburg, T. (2008). A shortened scale for overall, emotional and social loneliness. Tijdschrift voor Gerontologie en Geriatrie, 39, 4–15.Google ScholarPubMed
Devanand, D. P., Kim, M. K., Paykina, N. and Sackeim, H. A. (2002). Adverse life events in elderly patients with major depression or dysthymic disorder and healthy-control subjects. American Journal of Geriatric Psychiatry, 10, 265–274.CrossRefGoogle ScholarPubMed
Evans, W. J. (1995). Exercise, nutrition, and aging. Clinics of Geriatric Medicine, 11, 725–734.CrossRefGoogle ScholarPubMed
Fleg, J. L. and Lakatta, E. G. (1988). Role of muscle loss in the age-associated reduction in VO2 max. Journal of Applied Physiology, 65, 1147–1151.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Fried, L. P. et al. (2001). Frailty in older adults: evidence for a phenotype. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 56, 46–57.CrossRefGoogle ScholarPubMed
Fried, L. P., Ferrucci, L., Darer, J., Williamson, J. D. and Anderson, G. (2004). Untangling the concepts of disability, frailty and comorbidity: implications for improved targeting and care. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 59, 255–263.CrossRefGoogle ScholarPubMed
Jones, D. R., Macias, C., Barreira, P. J., Fisher, W. H., Hargreaves, W. A. and Harding, C. M. (2004). Prevalence, severity, and co-occurrence of chronic physical health problems of persons wih serious mental illness. Psychiatric Services, 55, 1250–1257.CrossRefGoogle Scholar
Kennedy, B. and Schwab, J. J. (1997). Utilisation of medical specialists by anxiety disorder patients. Psychosomatics, 38, 109–112.CrossRefGoogle ScholarPubMed
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.CrossRefGoogle ScholarPubMed
Leibel, R. L. (1995). Changes in energy expenditure resulting from altered body-weight. New England Journal of Medicine, 332, 621–628.CrossRefGoogle ScholarPubMed
Morley, J. E. (1997). Anorexia of aging: physiologic and pathologic. American Journal of Clinical Nutrition, 66, 760–773.CrossRefGoogle ScholarPubMed
Olafsdottir, M., Marcusson, J. and Skoog, I. (2001). Mental disorders among elderly people in primary care: the Linkoping study. Acta Psychiatrica Scandinavica, 104, 12–18.CrossRefGoogle ScholarPubMed
Tseng, B. S., Marsh, D. R., Hamilton, M. T. and Booth, F. W. (1995). Strength and aerobic training attenuate muscle wasting and improve resistance to the development of disability with aging. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 50, 113–119.Google Scholar
Turvey, C. L., Wallace, R. B. and Herzog, R. (1999). A revised CES-D measure of depressive symptoms and a DSM-based measure of major depressive episodes in the elderly. International Psychogeriatrics, 11, 139–148.CrossRefGoogle Scholar
Vink, D. (2008). Risk factors for anxiety and depression in the elderly: a review. Journal of Affective Disorders, 106, 29–44.CrossRefGoogle ScholarPubMed
Woods, N. F. et al. (2005). Frailty: emergence and consequences in women aged 65 and older in the Women's Health Inititative Observational Study. Journal of the American Geriatrics Society, 53, 1321–1330.CrossRefGoogle Scholar
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle ScholarPubMed