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Frailty, depression, and anxiety in later life

Published online by Cambridge University Press:  14 February 2012

Aine M. Ní Mhaoláin ,
Chie Wei Fan ,
Roman Romero-Ortuno ,
Lisa Cogan ,
Clodagh Cunningham ,
Rose-Anne Kenny  and
Brian Lawlor
Aine M. Ní Mhaoláin*
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland
Chie Wei Fan
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland
Roman Romero-Ortuno
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland
Lisa Cogan
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland
Clodagh Cunningham
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland
Rose-Anne Kenny
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland Department of Medical Gerontology, Trinity College Dublin, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland
Brian Lawlor
Affiliation:
TRIL Clinic (Technology Research for Independent Living), St James's Hospital, Dublin, Ireland Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
*
Correspondence should be addressed to: Dr Aine M. Ní Mhaoláin, TRIL Clinic, St James's Hospital, Dublin 8, Ireland. Phone: +35314164095; Fax: +35314103487. Email: ainemullen@gmail.com.
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Abstract

Background: Anxiety and depression are common in older people but are often missed; to improve detection we must focus on those elderly people at risk. Frailty is a geriatric syndrome inferring increased risk of poor outcomes. Our objective was to explore the relationship between frailty and clinically significant anxiety and depression in later life.

Methods: This study had a cross-sectional design and involved the assessment of 567 community-dwelling people aged ≥60 years recruited from the Technology Research for Independent Living (TRIL) Clinic, Dublin. Frailty was measured using the Fried biological syndrome model; depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale; and anxiety symptoms measured using the Hospital Anxiety and Depression Scale.

Results: Higher depression and anxiety scores were identified in both pre-frail and frail groups compared to robust elders (three-way factorial ANOVA, p ≤0.0001). In a logistic regression model the odds ratio for frailty showed a significantly higher likelihood of clinically meaningful depressive and anxiety symptoms even controlling for age, gender and a history of depression or anxiety requiring pharmacotherapy (OR = 4.3; 95% CI 1.5, 11.9; p = 0.005; OR = 4.36; 95% CI 1.4, 13.8; p = 0.013 respectively).

Conclusions: Our findings suggest that even at the earliest stage of pre-frailty, there is an association with increased symptoms of emotional distress; once frailty develops there is a higher likelihood of clinically significant depression and anxiety. Frailty may be relevant in identifying older people at risk of deteriorating mental health.

Keywords

frailtyanxietydepressionelderly
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Special Issue 8: Focus on late life depression , August 2012 , pp. 1265 - 1274
Copyright
Copyright © International Psychogeriatric Association 2012

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