Nursing Department, Universidad de Castilla-La Mancha, Albacete, Spain.
Geriatrics Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.
Int Psychogeriatr. 2021 Aug;33(8):803-812. doi: 10.1017/S1041610220003506. Epub 2020 Oct 20.
To investigate if depression risk modifies the association between frailty and mortality in older adults.
Ongoing cohort study.
Albacete city, Spain.
Eight hundred subjects, 58.8% women, over 70 years of age from the Frailty and Dependence in Albacete (FRADEA) study.
Frailty phenotype, Geriatric Depression Scale (GDS), comorbidity, disability, and drug use were collected at baseline. Six groups were categorized: (G1: non-frail/no depression risk; G2: non-frail/depression risk; G3: prefrail/no depression risk; G4: prefrail/depression risk; G5: frail/no depression risk; and G6: frail/depression risk). Mean follow-up was 2542 days (SD 1006). GDS was also analyzed as a continuous variable. The association between frailty and depression risk with 10-year mortality was analyzed.
Mean age was 78.5 years. Non-frail was 24.5%, prefrail 56.3%, frail 19.3%, and 33.5% at depression risk. Mean GDS score was 3.7 (SD 3.2), increasing with the number of frailty criteria (p < 0.001). Ten-year mortality rate was 44.9%. Mortality was 21.4% for the non-frail, 45.6% for the prefrail, and 72.7% for the frail participants, 56% for those with depression risk, and 39.3% for those without depression risk. Mean survival times for groups G1 to G6 were, respectively, 3390, 3437, 2897, 2554, 1887, and 1931 days. Adjusted mortality risk was higher for groups G3 (HR 2.1; 95% confidence interval (CI) 1.4-3.1), G4 (HR 2.5; 95% CI 1.7-3.8), G5 (HR 3.8; 95% CI 2.4-6.1), and G6 (HR 4.0; 95% CI 2.6-6.2), compared with G1 (p < 0.001). Interaction was found between frailty and depression risk, although they were independently associated with mortality.
Depression risk increases mortality risk in prefrail older adults but not in non-frail and frail ones. Depression should be monitored in these older adults to optimize health outcomes. Factors modulating the relationship between frailty and depression should be explored in future studies.
探讨抑郁风险是否会改变老年人衰弱与死亡率之间的关系。
正在进行的队列研究。
西班牙阿尔瓦塞特市。
来自衰弱和依赖阿尔瓦塞特（FRADEA）研究的 800 名受试者，年龄均在 70 岁以上，其中 58.8%为女性。
在基线时收集衰弱表型、老年抑郁量表（GDS）、合并症、残疾和药物使用情况。将 6 组分为：（G1：非虚弱/无抑郁风险；G2：非虚弱/有抑郁风险；G3：虚弱前/无抑郁风险；G4：虚弱前/有抑郁风险；G5：虚弱/无抑郁风险；G6：虚弱/有抑郁风险）。平均随访时间为 2542 天（SD 1006）。还分析了 GDS 作为连续变量。分析了衰弱和抑郁风险与 10 年死亡率之间的关系。
平均年龄为 78.5 岁。非虚弱者占 24.5%，虚弱前占 56.3%，虚弱者占 19.3%，有抑郁风险者占 33.5%。GDS 平均得分为 3.7（SD 3.2），随着衰弱标准数量的增加而增加（p<0.001）。10 年死亡率为 44.9%。非虚弱组的死亡率为 21.4%，虚弱前组为 45.6%，虚弱组为 72.7%，有抑郁风险组为 56%，无抑郁风险组为 39.3%。G1 到 G6 组的平均生存时间分别为 3390、3437、2897、2554、1887 和 1931 天。与 G1 相比，G3（HR 2.1；95%置信区间（CI）1.4-3.1）、G4（HR 2.5；95% CI 1.7-3.8）、G5（HR 3.8；95% CI 2.4-6.1）和 G6（HR 4.0；95% CI 2.6-6.2）的调整死亡率风险更高（p<0.001）。尽管衰弱和抑郁风险与死亡率独立相关，但研究发现它们之间存在交互作用。
抑郁风险增加了虚弱前期老年人的死亡风险，但对非虚弱和虚弱老年人没有影响。应监测这些老年人的抑郁情况，以优化健康结果。未来的研究应探讨调节衰弱和抑郁之间关系的因素。
