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Int Psychogeriatr. 2019 Mar;31(3):425-434. doi: 10.1017/S104161021800100X. Epub 2018 Aug 13.

Depression is associated with self-rated frailty in older adults from an outpatient clinic: a prospective study.

Author information

1
Division of Geriatrics,Department of Internal Medicine,University of São Paulo Medical School,São Paulo,Brazil.
2
Institute and Department of Psychiatry,Faculty of Medicine,University of São Paulo,São Paulo,São Paulo,Brazil.
3
Department of Internal Medicine,Faculty of Medicine of Jundiaí,Jundiaí,São Paulo,Brazil.

Abstract

ABSTRACTObjectives:The aim of the present study was to evaluate the association between depression and SSRI monotherapy and frailty both baseline and prospectively in older adults.

DESIGN:

Prospective cohort study, 12-month follow-up.

SETTING:

Geriatric outpatient clinic in São Paulo, Brazil.

PARTICIPANTS:

A total of 811 elderly adults aged 60 or older.

MEASUREMENTS:

Depression was diagnosed as follows: (1) a diagnosis of major depression disorder (MDD) according to DSM-5; or (2) an incomplete diagnosis of MDD, referred to as minor or subsyndromic depression, plus Geriatric Depression Scale 15-itens ≥ 6 points, and social or functional impairment secondary to depressive symptoms and observed by relatives. Frailty evaluation was performed through the FRAIL questionnaire, which is a self-rated scale. Trained investigators blinded to the baseline assessment conducted telephone calls to evaluate frailty after 12-month follow-up. The association between depression and the use of SSRI with frailty was estimated through a generalized estimating equation adjusted for age, gender, total drugs, and number of comorbidities.

RESULTS:

Depression with SSRI use was associated with frailty at baseline (OR 2.82, 95% CI = 1.69-4.69) and after 12 months (OR 2.75, 95% CI = 1.84-4.11). Additionally, depression with SSRI monotherapy was also associated with FRAIL subdomains Physical Performance (OR 1.99, 95% CI = 1.29-3.07) and Health Status (OR 4.64, 95% CI = 2.11-10.21). SSRI use, without significant depressive symptoms, was associated with subdomain Health Status (OR 1.52, 95% CI = 1.04-2.23).

CONCLUSION:

It appears that depression with SSRI is associated to frailty, and this association cannot be explained only by antidepressant use.

KEYWORDS:

antidepressants; clinical assessment; depression; geriatric medicine; outpatient

PMID:
30099972
DOI:
10.1017/S104161021800100X
[Indexed for MEDLINE]

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