4.5 Article

Frailty measures in immuno-metabolic subtypes of late-life depression; A two-year prospective study

期刊

出版社

ELSEVIER IRELAND LTD
DOI: 10.1016/j.archger.2021.104603

关键词

Late life depression; Frailty; Inflammation; Metabolic dysregulation

资金

  1. Fonds NutsOhra
  2. Stichting tot Steun VCVGZ
  3. NARSAD The Brain and Behaviour Research Fund
  4. VU University Medical Center
  5. Leiden University Medical Center
  6. University Medical Center Groningen
  7. Radboud University Nijmegen Medical Center
  8. GGZ inGeest
  9. GGNet
  10. GGZ Nijmegen
  11. Parnassia

向作者/读者索取更多资源

Frailty is more pronounced in late-life depression with more severe immuno-metabolic dysregulation. However, the trajectories of frailty measures over time do not differ significantly between subgroups, suggesting that the differences may have originated in midlife. Future studies should consider the relevance of geriatric assessment at earlier ages in specialized mental health care.
Background/Objectives - Frailty is highly prevalent with increasing age. Based on the concept of depression as a disorder of accelerated aging and its association with inflammation and metabolic dysregulation, we examined whether frailty measures at baseline and over time differed between immuno-metabolic subtypes of late-life depression. Methods - Clinical cohort study in primary and secondary mental health care with two-year follow-up. In total 359 depressed older patients (>= 60 years) classified in four immuno-metabolic subgroups by latent profile analysis. We compared frailty measures at baseline and two-year follow-up adjusted for confounders between immuno-metabolic based depressed subgroups. Frailty measures included the frailty index, physical frailty phenotype, and two proxies (handgrip strength, gait speed). Results - At baseline, the relatively healthy depressed subgroup (n = 181) performed best on all frailty markers. While frailty markers worsened over time, the two-year course did not differ between the subgroups for any of these markers. Conclusion - The more severe immuno-metabolic dysregulation present in late-life depression, the more frail. Nonetheless, as trajectories over time did not differ between subgroups, the difference probably emerged at midlife. Future studies should examine whether geriatric assessment might become relevant at earlier ages in specialized mental health care.

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