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Neuroimaging features of depression–frailty phenotype in older adults: a pilot study

Published online by Cambridge University Press:  20 February 2023

Ethan Shuster ,
Amy E. Miles ,
Lindsay K. Heyland ,
Navona Calarco ,
Jerrold Jeyachandra ,
Salim Mansour ,
Aristotle N. Voineskos ,
David C. Steffens Open the ORCID record for David C. Steffens [Opens in a new window] ,
Yuliya S. Nikolova  and
Breno S. Diniz Open the ORCID record for Breno S. Diniz [Opens in a new window]
Ethan Shuster
Affiliation:
UConn Center on Aging, University of Connecticut School of Medicine, Farmington, CT, USA
Amy E. Miles
Affiliation:
Centre for Addiction and Mental Health, Toronto, ON, Canada
Lindsay K. Heyland
Affiliation:
Centre for Addiction and Mental Health, Toronto, ON, Canada
Navona Calarco
Affiliation:
Centre for Addiction and Mental Health, Toronto, ON, Canada
Jerrold Jeyachandra
Affiliation:
Centre for Addiction and Mental Health, Toronto, ON, Canada
Salim Mansour
Affiliation:
Centre for Addiction and Mental Health, Toronto, ON, Canada
Aristotle N. Voineskos
Affiliation:
Centre for Addiction and Mental Health, Toronto, ON, Canada Department of Psychiatry, University of Toronto, Toronto, ON, Canada
David C. Steffens
Affiliation:
Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
Yuliya S. Nikolova
Affiliation:
Centre for Addiction and Mental Health, Toronto, ON, Canada Department of Psychiatry, University of Toronto, Toronto, ON, Canada
Breno S. Diniz*
Affiliation:
UConn Center on Aging, University of Connecticut School of Medicine, Farmington, CT, USA Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
*
Correspondence should be addressed to: Breno S. Diniz, Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06070, USA. Email: diniz@uchc.edu.
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Abstract

Objective:

Frailty and late-life depression (LLD) often coexist and share several structural brain changes. We aimed to study the joint effect LLD and frailty have on brain structure.

Design:

Cross-sectional study

Setting:

Academic Health Center

Participants:

Thirty-one participants (14 LLD+Frail and 17 Never-depressed+Robust)

Measurement:

LLD was diagnosed by a geriatric psychiatrist according to the Diagnostic and Statistical Manual of Mental Disorders 5th edition for single episode or recurrent major depressive disorder without psychotic features. Frailty was assessed using the FRAIL scale (0–5), classifying subjects as robust (0), prefrail (1–2), and frail (3–5). Participants underwent T1-weighted magnetic resonance imaging in which covariance analysis of subcortical volumes and vertex-wise analysis of cortical thickness values were performed to access changes in grey matter. Participants also underwent diffusion tensor imaging in which tract-based spatial statistics was used with voxel-wise statistical analysis on fractional anisotropy and mean diffusion values to assess changes in white matter (WM).

Results:

We found a significant difference in mean diffusion values (48,225 voxels; peak voxel: pFWER=0.005, MINI coord. (X,Y,Z) = −26,−11,27) between the LLD-Frail group and comparison group. The corresponding effect size (f=0.808) was large.

Conclusion:

We showed the LLD+Frailty group is associated with significant microstructural changes within WM tracts compared to Never-depressed+Robust individuals. Our findings indicate the possibility of a heightened neuroinflammatory burden as a potential mechanism underlying the co-occurrence of both conditions and the possibility of a depression–frailty phenotype in older adults.

Keywords

Late-life depressionFrailtyDiffusion Tensor Imaging
Type
Original Research Article
Information
International Psychogeriatrics , Volume 35 , Special Issue 12: Issue Theme: Depression and Suicide in Older Adults , December 2023 , pp. 717 - 723
Copyright
© International Psychogeriatric Association 2023

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