Interaction between frailty and depression in geriatric population in a hospital based prospective study

BACKGROUND: Depression and frailty are two closely related constructs in the elderly population but it is still not established whether treatment of depression will lead to improvement in the frailty status. The influence of frailty, both physical and multidimensional, at baseline on the outcome of depression also requires investigation. AIM: This study aimed at studying the changes in frailty status and depression severity after treatment of depression. The influence of baseline frailty on the outcome of depression was also investigated. METHODS: A cohort of sixty elderly adults (≥ 60 years) having depressive disorder (ICD-10 criteria) and meeting the inclusion and exclusion criteria were assessed at baseline and after a period of two-months (±twenty days) follow-up for depression and frailty. Depressive symptom severity was assessed with the Hamilton Rating Scale of Depression. Frailty was assessed according to the physical frailty phenotype and the Edmonton Frailty Scale. Other variables were assessed using a semi-structured proforma. Comparative analysis were done using paired t-test, Wilcoxon signed rank test and ANOVA. RESULTS: There was significant improvement in the phenotypic and multidimensional frailty (P value=0.001) after treatment for depression. The frailty status at baseline significantly influenced the outcome of depression. CONCLUSIONS: Antidepressants played a promising role in the treatment of frailty. The study findings point out to the fact that depression and frailty are probably manifestations of the same underlying pathophysiologic mechanisms. Future studies with larger sample size, longer follow up period and different methods of treatment of depression can be undertaken.