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Association between physical frailty and cognition in late-life depression

Published online by Cambridge University Press:  23 March 2020

M. Arts*
UMCG, Old Age Psychiatry, Groningen, Netherlands
R. Collard
Radboud UMC, Clinical Psychiatry, Nijmegen, Netherlands
H. Comijs
VU University Medical Center/GGZinGeest, Psychiatry, Amsterdam, Netherlands
M. Zuidersma
UMCG, University Center for Psychiatry, Groningen, Netherlands
S. de Rooij
UMCG, Clinical Geriatrics, Groningen, Netherlands
P. Naarding
GGNet, Old Age Psychiatry, Apeldoorn, Netherlands
R. Oude Voshaar
UMCG, Old Age Psychiatry, Groningen, Netherlands
*Corresponding author.


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Cognitive frailty has recently been defined as the co-occurrence of physical frailty and cognitive impairment. Late-life depression is associated with both physical frailty and cognitive impairment, especially processing speed and executive functioning.

Aim and objectives

In this study, we investigated the association between physical frailty and cognitive functioning in depressed older persons.


In a total of 378 patients (> 60 years) with depression according to DSM-IV criteria and a MMSE score of 24 points or higher, the physical frailty phenotype as well as its individual criteria (weight loss, weakness, exhaustion, slowness, low activity) was studied. Cognitive functioning was examined in 4 domains: verbal memory, working memory, interference control, and processing speed.


Of the 378 depressed patients (range 60–90 years; 66.1% women), 61 were classified as robust (no frailty criteria present), 214 as prefrail (1 or 2 frailty criteria present), and 103 as frail (> 3 criteria). Linear regression analyses, adjusted for confounders, showed that the severity of physical frailty was associated with poorer verbal memory, slower processing speed, and decreased working memory, but not with changes in interference control.


In late-life depression, physical frailty is associated with poorer cognitive functioning, although not consistently for executive functioning. Future studies should examine whether cognitive impairment in the presence of physical frailty belongs to cognitive frailty and is indeed an important concept to identify a specific subgroup of depressed older patients, who need multimodal treatment strategies integrating physical, cognitive, and psychological functioning.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Copyright © European Psychiatric Association 2016
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