Hsing-Yi Chang1,2, Hsin-Ling Fang1, Te-Tien Ting3, Jersey Liang4, Shao-Yuan Chuang1, Chih-Cheng Hsu1, Chin-Yin Wu5, Wen-Harn Pan1,2,6. 1. Institute of Population Health Sciences, National Health Research Institutes, Maoli, Taiwan. 2. Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. 3. School of Big Data Management, Soochow University, Taipei, Taiwan. 4. Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA. 5. Institute of Sociology, Academia Sinica, Taipei, Taiwan. 6. Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
Abstract
PURPOSE: The co-occurrence of frailty and depression in late life, the possibility for symptom reversal, their reciprocal relationship, and the effects on mortality have rarely been investigated. We aimed to examine the co-occurrence of frailty and depressive symptoms in late life, the possibility for symptom reversal, their reciprocal relationship, and the effects on mortality using all the information from a longitudinal study. PATIENTS AND METHODS: We used the Taiwan Longitudinal Study of Aging (TLSA) for this study. TLSA was initiated in 1989 and followed periodically. We included participants from 1989 to 2007, who had data on frailty and depressive symptoms. Frailty was assessed by accumulation of functional deficits in 6 dimensions including disease status, sensory dysfunction, balance, functional limitations, health risk behaviors, and life satisfaction. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). A multistate model with interval censoring was used to examine the transition between states of frailty with or without depressive symptoms, and finally to death. A mixed model was used to examine the relationships between frailty and depressive symptoms. RESULTS: The coexistence of frailty and depressive symptoms was associated with higher mortality. Individuals with depressive symptom had a lower probability of reversal to a better state. Previous depression score predicted current frailty, but the coefficient was smaller than that of previous frailty. Previous frailty predicted current depression score, and the coefficient was stronger than that of previous depression. CONCLUSION: Depressive symptoms increased the mortality and decreased the probability of reversal in the frail older adults.
PURPOSE: The co-occurrence of frailty and depression in late life, the possibility for symptom reversal, their reciprocal relationship, and the effects on mortality have rarely been investigated. We aimed to examine the co-occurrence of frailty and depressive symptoms in late life, the possibility for symptom reversal, their reciprocal relationship, and the effects on mortality using all the information from a longitudinal study. PATIENTS AND METHODS: We used the Taiwan Longitudinal Study of Aging (TLSA) for this study. TLSA was initiated in 1989 and followed periodically. We included participants from 1989 to 2007, who had data on frailty and depressive symptoms. Frailty was assessed by accumulation of functional deficits in 6 dimensions including disease status, sensory dysfunction, balance, functional limitations, health risk behaviors, and life satisfaction. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). A multistate model with interval censoring was used to examine the transition between states of frailty with or without depressive symptoms, and finally to death. A mixed model was used to examine the relationships between frailty and depressive symptoms. RESULTS: The coexistence of frailty and depressive symptoms was associated with higher mortality. Individuals with depressive symptom had a lower probability of reversal to a better state. Previous depression score predicted current frailty, but the coefficient was smaller than that of previous frailty. Previous frailty predicted current depression score, and the coefficient was stronger than that of previous depression. CONCLUSION: Depressive symptoms increased the mortality and decreased the probability of reversal in the frail older adults.
Authors: R A Schoevers; M I Geerlings; D J H Deeg; T J Holwerda; C Jonker; A T F Beekman Journal: Int J Geriatr Psychiatry Date: 2009-02 Impact factor: 3.485
Authors: Ulrike Dapp; Christoph E Minder; Jennifer Anders; Stefan Golgert; Wolfgang von Renteln-Kruse Journal: BMC Geriatr Date: 2014-12-19 Impact factor: 3.921