Richard C Oude Voshaar1, Menelaos Dimitriadis1, Rob H S van den Brink1, Ivan Aprahamian2, Marcus K Borges3, Radboud M Marijnissen1, Emiel O Hoogendijk4, Didi Rhebergen5, Hans W Jeuring1. 1. Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands. 2. Geriatrics Division, Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, Brazil. 3. Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil. 4. Department of Epidemiology and Biostatistics, Amsterdam UMC - location VU University medical center, Amsterdam, Netherlands. 5. Department of Psychiatry, Amsterdam UMC - location VU University medical center, Amsterdam, Netherlands & GGZ Ingeest Specialized Mental Health Care, Amsterdam, The Netherlands.
Abstract
INTRODUCTION: Depressive disorder has been conceptualised as a condition of accelerated biological ageing. We operationalized 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, two and six-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 six months by mail and telephone. An 41-item FI was operationalized 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 are 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. This article is protected by copyright. All rights reserved.
INTRODUCTION:Depressive disorder has been conceptualised as a condition of accelerated biological ageing. We operationalized 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, two and six-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 six months by mail and telephone. An 41-item FI was operationalized 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 depressedpatients (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 are 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. This article is protected by copyright. All rights reserved.
Entities:
Keywords:
Ageing; Biological ageing; Depressive disorder; Frailty; Frailty Index
Authors: Ivan Aprahamian; Marcus K Borges; Denise J C Hanssen; Hans W Jeuring; Richard C Oude Voshaar Journal: Clin Interv Aging Date: 2022-06-22 Impact factor: 3.829