Patrick J Brown1, Steven P Roose2, Robert Fieo3, Xinhua Liu4, Taina Rantanen5, Joel R Sneed6, Bret R Rutherford2, D P Devanand2, Kirsten Avlund7. 1. Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY. Electronic address: pb2410@columbia.edu. 2. Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY. 3. Sergievsky Center and the Taub Institute, Columbia University College of Physicians and Surgeons, New York, NY. 4. Division of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY. 5. The Finnish Centre for Interdisciplinary Gerontology, University of Jyväskylä, Jyväskylä, Finland. 6. Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY; Queens College, City University of New York, New York, NY. 7. Department of Public Health and Center for Health Ageing, University of Copenhagen, Copenhagen, Denmark; Danish Aging Research Centre, Universities of Aarhus, Southern Denmark and Copenhagen, Denmark.
Abstract
OBJECTIVE: To identify salient characteristics of frailty that increase risk of death in depressed elders. METHODS: Data were from the Nordic Research on Ageing Study from research sites in Denmark, Sweden, and Finland. Participants were 1,027 adults aged 75 years (436 men and 591 women). Time of death was obtained, providing a maximum survival time of 11.08 years (initial evaluation took place between 1988 and 1991). RESULTS: Depressed elders showed greater baseline impairments in each frailty characteristic (gait speed, grip strength, physical activity levels, and fatigue). Simultaneous models including all four frailty characteristics showed slow gait speed (hazard ratio: 1.84; 95% confidence interval: 1.05-3.21) and fatigue (hazard ratio: 1.94; 95% confidence interval: 1.11-3.40) associated with faster progression to death in depressed women; none of the frailty characteristics in the simultaneous model was associated with death in depressed men. In women, the effect of impaired gait speed on mortality rates nearly doubled when depression was present (nondepressed women: no gait impairment = 26%; slow gait = 40%; depressed women: no gait impairment = 32%; slow gait = 58%). A similar pattern was observed for fatigue. CONCLUSION: The confluence of specific characteristics of frailty (fatigue and slow gait speed) and depressive illness is associated with an increased risk of death in older adults; this association is particularly strong in older depressed women. Future research should investigate whether multimodal interventions targeting depressive illness, mobility deficits, and fatigue can decrease mortality and improve quality of life in older depressed individuals with characteristics of the syndrome of frailty.
OBJECTIVE: To identify salient characteristics of frailty that increase risk of death in depressed elders. METHODS: Data were from the Nordic Research on Ageing Study from research sites in Denmark, Sweden, and Finland. Participants were 1,027 adults aged 75 years (436 men and 591 women). Time of death was obtained, providing a maximum survival time of 11.08 years (initial evaluation took place between 1988 and 1991). RESULTS: Depressed elders showed greater baseline impairments in each frailty characteristic (gait speed, grip strength, physical activity levels, and fatigue). Simultaneous models including all four frailty characteristics showed slow gait speed (hazard ratio: 1.84; 95% confidence interval: 1.05-3.21) and fatigue (hazard ratio: 1.94; 95% confidence interval: 1.11-3.40) associated with faster progression to death in depressed women; none of the frailty characteristics in the simultaneous model was associated with death in depressed men. In women, the effect of impaired gait speed on mortality rates nearly doubled when depression was present (nondepressed women: no gait impairment = 26%; slow gait = 40%; depressed women: no gait impairment = 32%; slow gait = 58%). A similar pattern was observed for fatigue. CONCLUSION: The confluence of specific characteristics of frailty (fatigue and slow gait speed) and depressive illness is associated with an increased risk of death in older adults; this association is particularly strong in older depressed women. Future research should investigate whether multimodal interventions targeting depressive illness, mobility deficits, and fatigue can decrease mortality and improve quality of life in older depressed individuals with characteristics of the syndrome of frailty.
Authors: Daniel K White; Tuhina Neogi; Michael C Nevitt; Christine E Peloquin; Yanyan Zhu; Robert M Boudreau; Jane A Cauley; Luigi Ferrucci; Tamara B Harris; Susan M Satterfield; Eleanor M Simonsick; Elsa S Strotmeyer; Yuqing Zhang Journal: J Gerontol A Biol Sci Med Sci Date: 2012-10-09 Impact factor: 6.053
Authors: L P Fried; C M Tangen; J Walston; A B Newman; C Hirsch; J Gottdiener; T Seeman; R Tracy; W J Kop; G Burke; M A McBurnie Journal: J Gerontol A Biol Sci Med Sci Date: 2001-03 Impact factor: 6.053
Authors: Patrick J Brown; Xinhua Liu; Joel R Sneed; Monique A Pimontel; D P Devanand; Steven P Roose Journal: Am J Geriatr Psychiatry Date: 2013-02-06 Impact factor: 4.105
Authors: Susan L Lakey; Andrea Z LaCroix; Shelly L Gray; Soo Borson; Carla D Williams; Darren Calhoun; Joseph S Goveas; Jordan W Smoller; Judith K Ockene; Kamal H Masaki; Mace Coday; Milagros C Rosal; Nancy F Woods Journal: J Am Geriatr Soc Date: 2012-05-09 Impact factor: 5.562
Authors: Lauren R Pollack; Nathan E Goldstein; Wendy C Gonzalez; Craig D Blinderman; Mathew S Maurer; David J Lederer; Matthew R Baldwin Journal: J Am Geriatr Soc Date: 2017-03-06 Impact factor: 5.562
Authors: Patrick J Brown; Melanie M Wall; Chen Chen; Morgan E Levine; Kristine Yaffe; Steven P Roose; Bret R Rutherford Journal: J Gerontol A Biol Sci Med Sci Date: 2018-09-11 Impact factor: 6.053
Authors: Patrick J Brown; Steven P Roose; Jun Zhang; Melanie Wall; Bret R Rutherford; Hilsa N Ayonayon; Meryl A Butters; Tamara Harris; Anne B Newman; Suzanne Satterfield; Eleanor M Simonsick; Kristine Yaffe Journal: J Gerontol A Biol Sci Med Sci Date: 2015-09-20 Impact factor: 6.053
Authors: Justin S Golub; Adam M Brickman; Adam J Ciarleglio; Nicole Schupf; José A Luchsinger Journal: J Gerontol A Biol Sci Med Sci Date: 2020-02-14 Impact factor: 6.053
Authors: Eric J Lenze; Alex Ramsey; Patrick J Brown; Charles F Reynolds; Benoit H Mulsant; Helen Lavretsky; Steven P Roose Journal: Am J Geriatr Psychiatry Date: 2016-07-29 Impact factor: 4.105
Authors: Allison M Gustavson; Jason R Falvey; Jeri E Forster; Jennifer E Stevens-Lapsley Journal: J Geriatr Phys Ther Date: 2019 Jul/Sep Impact factor: 3.381
Authors: Patrick J Brown; Bret R Rutherford; Kristine Yaffe; Jane M Tandler; Justina Laurence Ray; Emily Pott; Sarah Chung; Steven P Roose Journal: Am J Geriatr Psychiatry Date: 2016-06-23 Impact factor: 4.105