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Frailty, depression risk, and 10-year mortality in older adults: the FRADEA study

Published online by Cambridge University Press:  20 October 2020

Marta Carolina Ruiz-Grao ,
Pedro Manuel Sánchez-Jurado ,
Milagros Molina-Alarcón ,
Antonio Hernández-Martínez ,
Almudena Avendaño Céspedes  and
Pedro Abizanda Open the ORCID record for Pedro Abizanda [Opens in a new window]
Marta Carolina Ruiz-Grao
Affiliation:
Nursing Department, Universidad de Castilla-La Mancha, Albacete, Spain
Pedro Manuel Sánchez-Jurado
Affiliation:
Geriatrics Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain CIBERFES, Instituto de Salud Carlos III, Madrid, Spain
Milagros Molina-Alarcón
Affiliation:
Nursing Department, Universidad de Castilla-La Mancha, Albacete, Spain
Antonio Hernández-Martínez
Affiliation:
Nursing Department, Universidad de Castilla-La Mancha, Albacete, Spain
Almudena Avendaño Céspedes
Affiliation:
Geriatrics Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain CIBERFES, Instituto de Salud Carlos III, Madrid, Spain
Pedro Abizanda*
Affiliation:
Geriatrics Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain CIBERFES, Instituto de Salud Carlos III, Madrid, Spain
*
Correspondence should be addressed to: Pedro Abizanda, Hospital Perpetuo Socorro, Complejo Hospitalario Universitario de Albacete, C/Seminario 4, Albacete02006, Spain. Phone: +34967597651. Fax: +34967597635. Email: pabizanda@sescam.jccm.es.
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Abstract

Objectives:

To investigate if depression risk modifies the association between frailty and mortality in older adults.

Design:

Ongoing cohort study.

Setting:

Albacete city, Spain

Participants:

Eight hundred subjects, 58.8% women, over 70 years of age from the Frailty and Dependence in Albacete (FRADEA) study.

Measurements:

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.

Results:

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.

Conclusions:

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.

Keywords

frailtydepressionmortalityolder adultscomorbidity
Type
Original Research Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 8: Issue Theme: Longitudinal Studies of Aging , August 2021 , pp. 803 - 812
Copyright
© International Psychogeriatric Association 2020

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