The relationship of frailty and disability with suicidal ideation in late life depression

Abstract

Objectives

Frailty and disability are commonly found in Late Life Depression (LLD) and have been associated with increased depression severity, health comorbidities and mortality. Additionally, physical frailty has been associated with suicide in later life, independent of presence of a mood disorder. The objective of our study was to assess the associations of physical frailty and functional disability with suicidal ideation, controlling for depression severity and demographic factors, in an older depressed sample.

Methods

This study used data from community-dwelling older adults with major depression. Eligible participants were ≥ 65 years old, completed measures of depression symptom severity (Hamilton Depression Rating Scale-24 item; HDRS-24), current suicidal ideation (Geriatric Suicide Ideation Scale; GSIS), and physical frailty/functional capacity measures.

Results

Participants were 88 older adults with a mean age of 71.5 (SD = 6.0) and 66% of the sample was female. Poorer performance on frailty measures of gait speed (B = .239, p = .003) and muscle weakness (B = −.218, p = .01) were significantly associated with higher levels of suicidal ideation, independent of depression severity and demographic factors. Functional disability was also significantly related to suicide ideation, specifically impairment in financial capacity (B = −.290, p = .008), social interaction (B = .408, p < .001), and communication skills (B = .373, p = .001).

Conclusion

Our findings show that, in LLD, frailty and functional disability are significantly associated with higher levels of suicide ideation, independent of depression symptom severity.

Keywords:

• Aging
• frailty
• disability
• suicide
• late life depression

Disclosure statement

David Bickford has nothing to disclose; Dr. Morin has nothing to disclose; Cara Woodworth has nothing to disclose; Elizabeth Verduzco has nothing to disclose; Maryam Khan has nothing to disclose; Emily Burns has nothing to disclose; Dr. Nelson reports personal fees from Assurex, personal fees from Eisia, personal fees from Janssen, personal fees from Lundbeck, personal fees from Otsuka, personal fees from Sunovion, personal fees from Biohaven, personal fees from FVS-7, and personal fees from UpToDate, outside the submitted work; Dr. Mackin reports grants from National Institute of Mental Health, personal fees from Johnson and Johnson, outside the submitted work.

Additional information

Funding

This work was supported by R01 MH098062: (PI:Mackin), R01 MH101472 (PI:Mackin); UCSF Epstein Endowment Fund. This research is also supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment, Sierra Pacific Mental Illness Research Education and Clinic Centers, San Francisco VA Medical Center.