Department of Old Age Psychiatry, ProPersona, Arnhem/Wolfheze, the Netherlands; University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion regulation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Arch Gerontol Geriatr. 2022 Mar-Apr;99:104603. doi: 10.1016/j.archger.2021.104603. Epub 2021 Dec 1.
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.
背景/目的-衰弱随着年龄的增长而高度流行。基于抑郁作为加速衰老障碍的概念及其与炎症和代谢失调的关联，我们研究了在基线和随访期间，不同的老年期抑郁症免疫代谢亚型之间是否存在不同的衰弱测量值。方法-对初级和二级精神卫生保健进行了临床队列研究，随访时间为两年。通过潜在剖面分析，将 359 名年龄≥60 岁的抑郁老年患者分为四个免疫代谢亚组。我们比较了基于免疫代谢的抑郁亚组之间，在调整混杂因素后，基线和两年随访时的衰弱测量值。衰弱测量包括衰弱指数、身体衰弱表型和两个替代指标（握力、步态速度）。结果-在基线时，相对健康的抑郁亚组（n=181）在所有衰弱标志物上表现最好。虽然衰弱标志物随时间恶化，但在这些标志物中，任何一个亚组的两年病程都没有差异。结论-老年期抑郁症中存在更严重的免疫代谢失调，衰弱程度越严重。尽管如此，由于亚组之间的时间轨迹没有差异，这种差异可能出现在中年。未来的研究应该研究在专门的精神卫生保健中，老年评估是否可能在更早的年龄变得相关。
