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

Published online by Cambridge University Press:  13 August 2018

Ivan Aprahamian ,
Claudia Kimie Suemoto ,
Sumika Mori Lin ,
Alaise Silva Santos de Siqueira ,
Marina Maria Biella ,
Brian Alvarez Ribeiro de Melo  and
Wilson Jacob-Filho
Ivan Aprahamian*
Affiliation:
Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil Institute and Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil
Claudia Kimie Suemoto
Affiliation:
Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
Sumika Mori Lin
Affiliation:
Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
Alaise Silva Santos de Siqueira
Affiliation:
Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil Institute and Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
Marina Maria Biella
Affiliation:
Institute and Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
Brian Alvarez Ribeiro de Melo
Affiliation:
Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, São Paulo, Brazil
Wilson Jacob-Filho
Affiliation:
Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil
*
Correspondence should be addressed to: Ivan Aprahamian, MD, MS, PhD, FACP, Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, 8° Andar, Bloco 3, São Paulo, SP 05403-900, Brazil. Phone: +55-11-26618116. Email: ivan.aprahamian@gmail.com.
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Abstract

Objectives:

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

depressionantidepressantsclinical assessmentgeriatric medicineoutpatient
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 3: Issue Theme: Caregiving for People with Dementia , March 2019 , pp. 425 - 434
Copyright
Copyright © International Psychogeriatric Association 2018 

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