Worsening Frailty Status Linked to Incident Depression

Based on findings from a recent study, researchers suggest that a worsening in frailty status can lead to an almost two-fold increased risk of incident depression, regardless of the initial level of impairment (Am J Geriatr Psychiatr. 2017;25[2]:190-197). 

Researchers lead by Marina De Rui, MD, Geriatrics Division, University of Padova (Padova, Italy), initially sought to evaluate whether prefrailty may be associated with risk of developing depression and if longitudinal changes in frailty status corresponded to changes in incident depression during follow up. 

A population-based, prospective, cohort study was conducted for 4.4 years in two separate geographic locations in northern Italy and included 891 nondepressed, nonfrail adults aged 65 or older (46.6% men). Depression was defined using the Geriatric Depression Scale and was confirmed by geriatricians skilled in psychogeriatric medicine. Prefrailty was defined by the presence of one or two criteria among the Fried criteria.

Authors found that prefrailty at baseline did not predict the onset of depression. In addition, improvement in frailty status was not associated with the risk of incident depression. However, deterioration at follow up in at least one additional frailty criteria was associated with a significantly higher risk of depression. Among older adults whose frailty status improved at follow up, there was a depression incidence rate of 13.3% (n = 15); in those who remained stable, 15.0% (n = 79); and among worsening participants, 26.7% (n = 67) (P = .001). 

In conclusion, authors said that while “data did not offer evidence that prefrailty per se predisposes to the onset of depression,” worsening frailty status leads to a significantly increased risk for incident depression, irrespective of initial impairment.—Amanda Del Signore