A 6-year prospective clinical cohort study on the bidirectional association between frailty and depressive disorder

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Citações na Scopus
20
Tipo de produção
article
Data de publicação
2021
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Autores
VOSHAAR, Richard C. Oude
DIMITRIADIS, Menelaos
VANDENBRINK, Rob H. S.
APRAHAMIAN, Ivan
MARIJNISSEN, Radboud M.
HOOGENDIJK, Emiel O.
RHEBERGEN, Didi
JEURING, Hans W.
Citação
INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, v.36, n.11, p.1699-1707, 2021
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Introduction Depressive disorder has been conceptualised as a condition of accelerated biological ageing. We operationalised a frailty index (FI) as marker for biological ageing aimed to explore the bidirectional, longitudinal association between frailty and either depressive symptoms or depressive disorder. Methods A cohort study with 6-year follow-up including 377 older (>= 60 years) outpatients with a DSM-IV-defined depressive disorder and 132 never-depressed controls. Site visits at baseline, 2 and 6-year follow-up were conducted and included the CIDI 2.0 to assess depressive disorder and relevant covariates. Depressive symptom severity and mortality were assessed every 6 months by mail and telephone. A 41-item FI was operationalised and validated against the 6-year morality rate by Cox regression (HRFI = 1.04 [95% CI: 1.02-1.06]). Results Cox regression showed that a higher FI was associated with a lower chance of remission among depressed patients (HRFI = 0.98 [95% CI: 0.97-0.99]). Nonetheless, this latter effect disappeared after adjustment for baseline depressive symptom severity. Linear mixed models showed that the FI increased over time in the whole sample (B[SE] = 0.94 (0.12), p < .001) with a differential impact of depressive symptom severity and depressive disorder. Higher baseline depressive symptom severity was associated with an attenuated and depressive disorder with an accelerated increase of the FI over time. Conclusions The sum score of depression rating scales is likely confounded by frailty. Depressive disorder, according to DSM-IV criteria, is associated with accelerated biological ageing. This argues for the development of multidisciplinary geriatric care models incorporating frailty to improve the overall outcome of late-life depression.
Palavras-chave
ageing, biological ageing, depressive disorder, frailty, frailty index
URI
https://observatorio.fm.usp.br/handle/OPI/44033
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Coleções
Artigos e Materiais de Revistas Científicas - FM/Outros