Could Frailty be an Explanatory Factor of the Association between Depression and Other Geriatric Syndromes in Later Life?

ABSTRACT

Objectives

This study aimed to investigate whether frailty could be an explanatory factor of the association between depression and the number of geriatric syndromes.

Methods

Cross-sectional baseline data from a cohort study (MiMiCS-FRAIL) were analyzed in a sample of 315 older adults. Depression was measured according to DSM-5 criteria and a self-report questionnaire (PHQ-9). Frailty was assessed according to the FRAIL questionnaire and a 30-item Frailty Index (FI). We considered six geriatric syndromes. Multiple linear regression analyses were performed and adjusted for potential confounders.

Results

Multiple linear regression analyses yielded significant associations between depression and geriatric syndromes. These associations decreased substantially in strength when frailty was added to the models. Findings were consistent for different definitions of depression and frailty.

Conclusions

Among depressed patients, frailty may be hypothesized as a causal pathway toward adverse health outcomes associated with depression. Longitudinal studies should explore the causality of this association.

Clinical implications

Frailty should be treated or prevented in order to minimize the impact of other geriatric syndromes among depressed older adults. Screening for frailty would be of utmost importance in mental health care, as frailty is neglected especially in this field. Integrated care models are crucial for clinical practice in mental illness care.

KEYWORDS:

• Frailty
• depression
• geriatric syndromes
• multimorbidity
• older adults

Clinical implications

• Frailty should be treated or prevented in order to minimize the impact of other geriatric syndromes among depressed older adults.

• Screening for frailty would be of utmost importance in mental health care, as frailty is neglected especially in this field.

• Integrated care models are crucial for clinical practice in mental illness care.

Acknowledgments

Prof Aprahamian received a national public grant level two from the National Council for Scientific and Technological Development (Ministry of Science, Technology, Innovation and Communications, Brazil).

Disclosure statement

The authors declare no conflict of interest.

Role of the funder

The funder of this research did not have any role in the design and conduct of the study; collection, management, analysis, and interpretation of data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

Additional information

Funding

This study was financed in part by the “Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (Capes)” – Finance Code 001.