Frailty and depressive symptoms in older adults: data from the FIBRA study - UNICAMP

Study on the quality of life and its related factors for older adults in communities in Beijing, China†

Objectives

To describe the quality of life (QOL) of adults ≥60 years of age in communities in Beijing and explore demographic, clinical, and psychological factors associated with QOL.

Methods

This was a cross-sectional study. A total of 363 older adults were recruited, in which 313 completed the questionnaires. Depressive symptoms were measured with the Self-Rating Depression Scale (SDS) and QOL was analyzed with the 36-item short form (SF-36). The t-test and Mann-Whitney U tests were used to compare QOL by gender and age group. Factors associated with QOL were determined using multiple linear regression.

Results

Among 313 older adults, depressive symptoms were observed to be prevalent to the extent of 16.6%. Overall, participants had higher QOL in the domains of social role functioning and emotional role functioning, with lower QOL in the domains of physical functioning and general health perceptions. There were no significant differences in QOL between women and men. However, there were significant differences between different age groups, with older adults having better mental QOL than younger adults. Better physical QOL was associated with less depressive symptoms, having a partner, and younger age (R 2 = 28.7%). Better mental QOL was associated with less depressive symptoms, less chronic disease, and older age (R 2 = 34.7%).

Conclusions

With aging, physical QOL was lower and mental QOL was better. Less depressive symptoms, having a spouse or partner, and young–old age assert positive influence on physical QOL of the older adults; and less depressive symptoms, no chronic disease, and older age assert positive influence on mental QOL.

Longitudinal Association between Late-Life Depression (LLD) and Frailty: Findings from a Prospective Cohort Study (MiMiCS-FRAIL)

OBJECTIVES

The aim of the present study was to investigate whether late-life depression (LLD) is associated with incident frailty over time.

DESIGN

Prospective cohort study, one-year follow-up.

SETTING

Geriatric outpatient clinic, Southwestern of Brazil.

PARTICIPANTS

181 follow-up participants aged 60 years or over.

MEASUREMENTS

Depressive disorders were classified as Major Depressive disorder (MDD) or Subthreshold Depression (STD) according to DSM-5 criteria. Depressive symptoms were assessed with validated versions of 15-item Geriatric Depression Scale (GDS-15) and 9-item Patient Health Questionnaire (PHQ-9). We performed binary logistic regressions to estimate the odds ratio (OR) for frailty in LLD adjusting for multiple confounders. Participants who were frail at baseline were excluded from the analyses according to measures of frailty (FRAIL questionnaire and 36-item Frailty Index, FI-36). We also estimated the risk ratio or relative risk (RR) and the risk difference (RD) for incident frailty.

RESULTS

We observed a 2 to 4-fold increased risk for incident frailty among participants with LLD. The presence of a depressive disorder was significantly associated with the onset of frailty (adjusted OR for FRAIL and FI-36: 3.07 [95% CI = 1.03 - 9.17] and 3.76 [95% CI = 1.09 - 12.97], respectively. Notably, the risk for frailty due to LLD was significantly higher with the FI-36 compared to the FRAIL (RR: 3.03 versus 2.23). RD was of 17.3% and 12.7% with the FRAIL and the FI-36, respectively.

CONCLUSION

Our data support the association between LLD and incident frailty over one year among geriatric outpatients, reinforcing longitudinal evidence from population-based studies.

Factors associated with poor physical performance in older adults of 11 Peruvian high Andean communities

Background: Physical performance in the older adult has been extensively studied. However, only a few studies have evaluated physical performance among older adults of high Andean populations and none have studied the factors associated with it. The objective of this study was to evaluate factors associated with poor physical performance by using the Short Physical Performance Battery (SPPB) in older adults living in 11 Peruvian high Andean communities.

Methods: An analytical cross-sectional study was carried out in inhabitants aged 60 or over from 11 high-altitude Andean communities of Peru during 2013-2017. Participants were categorized in two groups according to their SPPB score: poor physical performance (0-6 points) and medium/good physical performance (7-12 points). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor physical performance. Prevalence ratio (PR) with 95% confidence intervals (95 CI%) are presented.

Results: A total of 407 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60-94 years) and 181 (44.5%) participants had poor physical performance (0-6 points). In the adjusted Poisson regression analysis, the factors associated with poor physical performance were: female gender (PR=1.29; 95%CI: 1.03-1.61), lack of social support (PR=2.10; 95%CI: 1.17-3.76), number of drugs used (PR=1.09; 95%CI: 1.01-1.17), urinary incontinence (PR=1.45; 95%CI: 1.16-1.82), exhaustion (PR=1.35; 95%CI: 1.03-1.75) and cognitive impairment (PR=1.89; 95%CI: 1.40-2.55).

Conclusions: Almost half of the population evaluated had poor physical performance based on the SPPB. Factors that would increase the possibility of suffering from poor physical performance were: female gender, lack of social support, number of drugs used, urinary incontinence, exhaustion and cognitive impairment. Future studies with a larger sample and longitudinal follow-up are needed to design beneficial interventions for the high Andean population.

Prevalence of frailty and its association with depressive symptoms among older adults in Singapore

OBJECTIVES

The aims of the study were to (1) estimate the prevalence of frailty among community-dwelling older adults , and (2) investigate the independent association between level of frailty and depressive symptoms.

METHODS

A total of 721 older adults (aged 60 and above ) were included in this study. Severity of frailty was determined using the Clinical Frailty Scale and further classified into four levels (CFS1-3: F1, CFS4: F2, CFS5: F3, and CFS6-7: F4). The depressive symptoms were assessed using the Patient Health Questionnaire-9. The prevalence of frailty by four levels was described and the association between level of frailty and depressive symptoms was assessed using multiple linear regression.

RESULTS

The prevalence of frailty among the study population was 24.5% (F2: 14.4%, F3:3.7%, F4: 6.4%). There was no significant difference in level of frailty between male and female. With the increase in severity level of frailty, older adults reported substantially higher depressive symptom scores (p < .001), even after controlling for socio-demographics, number of non-mental chronic conditions, and number of medications taken regularly.

CONCLUSIONS

Level of frailty is independently associated with depressive symptoms among community-dwelling older population, which is not fully explained by symptom overlap, socio-demographic, and comorbidity covariates.