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Effect of Frailty on Depression among Patients with Late-life Depression: A Test of Anger, Anxiety, and Resilience as Mediators

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Objective: While the association between depression and frailty in the elderly population has been investigated, the psychological factors that mediate such a relationship remain unknown. The identification of psychological factors in interventions for depression treatment in the elderly may assist in the treatment and care. We aimed to explore the mediating effects of anger, anxiety, and resilience on the link between frailty and depression symptoms in patients with late-life depression. Methods: A sample of 203 older adults completed questionnaires that assessed depression, anger, resilience, and anxiety. To measure frailty, participants were evaluated using a self-rated health questionnaire, weight-adjusted waist index related to sarcopenia, and weight-adjusted handgrip strength to evaluate weakness. A mediation model was tested, hypothesizing that anger, anxiety, and resilience would partially mediate the strength of the frailty-depression link in the elderly. Results: Only self-rated health showed a significant association with depressive symptoms in late-life depression. Our study demonstrated that frailty has both direct and indirect associations with depression, mediated by anger, resilience, and anxiety. Conclusion: Given that anger, resilience, and anxiety influence the link between self-rated health and depression, interventions that lead to increased resilience and decreased anger and anxiety may be promising to reduce depressive symptoms in older adults with depression.

Abstract

Objective: While the association between depression and frailty in the elderly population has been investigated, the psychological factors that mediate such a relationship remain unknown. The identification of psychological factors in interventions for depression treatment in the elderly may assist in the treatment and care. We aimed to explore the mediating effects of anger, anxiety, and resilience on the link between frailty and depression symptoms in patients with late-life depression. Methods: A sample of 203 older adults completed questionnaires that assessed depression, anger, resilience, and anxiety. To measure frailty, participants were evaluated using a self-rated health questionnaire, weight-adjusted waist index related to sarcopenia, and weight-adjusted handgrip strength to evaluate weakness. A mediation model was tested, hypothesizing that anger, anxiety, and resilience would partially mediate the strength of the frailty-depression link in the elderly. Results: Only self-rated health showed a significant association with depressive symptoms in late-life depression. Our study demonstrated that frailty has both direct and indirect associations with depression, mediated by anger, resilience, and anxiety. Conclusion: Given that anger, resilience, and anxiety influence the link between self-rated health and depression, interventions that lead to increased resilience and decreased anger and anxiety may be promising to reduce depressive symptoms in older adults with depression.

참고문헌 (54)

  1. American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (2013), American Psychiatric Association
  2. Chi S, "The prevalence of depression in Alzheimer's disease : a systematic review and meta-analysis", Curr Alzheimer Res, 12, pp.189~198 (2015)
  3. Diniz BS, "Plasma biosignature and brain pathology related to persistent cognitive impairment in late-life depression", Mol Psychiatry, 20, pp.594~601 (2015)
  4. Findings from the global burden of disease study 2017, "Institute for Health Metrics and Evaluation (IHME)", IHME, ~ (2017)
  5. Rockwood K, "Frailty in relation to the accumulation of deficits", J Gerontol A Biol Sci Med Sci, 62, pp.722~727 (2007)
  6. Xue QL, "The frailty syndrome : definition and natural history", Clin Geriatr Med, 27, pp.1~15 (2011)
  7. Fried LP, "Frailty in older adults: evidence for a phenotype", J Gerontol A Biol Sci Med Sci, 56, pp.M146~M156 (2001)
  8. Buttery AK, "Prevalence and correlates of frailty among older adults : findings from the German health interview and examination survey", BMC Geriatr, 15, pp.22~ (2015)
  9. Gale CR, "Prevalence of frailty and disability : findings from the English Longitudinal Study of Ageing", Age Ageing, 44, pp.162~165 (2015)
  10. Chu W, "The relationship between depression and frailty in community-dwelling older people : a systematic review and meta-analysis of 84, 351 older adults", J Nurs Scholarsh, 51, pp.547~559 (2019)
  11. Vaughan L, "Depression and frailty in later life : a systematic review", Clin Interv Aging, 10, pp.1947~1958 (2015)
  12. Hayashi T, "Association between sarcopenia and depressive mood in urban-dwelling older adults : a cross-sectional study", Geriatr Gerontol Int, 19, pp.508~512 (2019)
  13. Noh HM, "Handgrip strength, dynapenia, and mental health in older Koreans", Sci Rep, 10, pp.4004~ (2020)
  14. Boutari C, "Decreasing lean body mass with age : challenges and opportunities for novel therapies", Endocrinol Metab(Seoul), 32, pp.422~425 (2017)
  15. Roubenoff R, "Sarcopenic obesity : the confluence of two epidemics", Obes Res, 12, pp.887~888 (2004)
  16. Aubertin-Leheudre M, "Effect of sarcopenia on cardiovascular disease risk factors in obese postmenopausal women", Obesity(Silver Spring), 14, pp.2277~2283 (2006)
  17. Stenholm S, "Sarcopenic obesity : definition, cause and consequences", Curr Opin Clin Nutr Metab Care, 11, pp.693~700 (2008)
  18. Chung JY, "Body composition and its association with cardiometabolic risk factors in the elderly : a focus on sarcopenic obesity", Arch Gerontol Geriatr, 56, pp.270~278 (2013)
  19. Jang HC, "Sarcopenia, frailty, and diabetes in older adults", Diabetes Metab J, 40, pp.182~189 (2016)
  20. Idler EL, "Self-rated health and mortality : a review of twenty-seven community studies", J Health Soc Behav, 38, pp.21~37 (1997)
  21. Jylhä M, "What is self-rated health and why does it predict mortality? Towards a unified conceptual model", Soc Sci Med, 69, pp.307~316 (2009)
  22. Freyler A, "Modern health worries in patients with affective disorders. A pilot study", Ideggyogy Sz, 72, pp.337~341 (2019)
  23. Molarius A, "Self-rated health, chronic diseases, and symptoms among middle-aged and elderly men and women", J Clin Epidemiol, 55, pp.364~370 (2002)
  24. Alexopoulos GS, "Mechanisms and treatment of late-life depression", Transl Psychiatry, 9, pp.188~ (2019)
  25. Kazantzis N, "The processes of cognitive behavioral therapy : a review of meta-analyses", Cognit Ther Res, 42, pp.349~357 (2018)
  26. Clarke DM, "Demoralization, anhedonia and grief in patients with severe physical illness", World Psychiatry, 4, pp.96~105 (2005)
  27. Painuly N, "Relationship of anger and anger attacks with depression : a brief review", Eur Arch Psychiatry Clin Neurosci, 255, pp.215~222 (2005)
  28. Ní Mhaoláin AM, "Frailty, depression, and anxiety in later life", Int Psychogeriatr, 24, pp.1265~1274 (2012)
  29. Östberg D, "Three-year prediction of depression and anxiety with a single self-rated health item", J Ment Health, 31, pp.402~409 (2022)
  30. Wermelinger Ávila MP, "Association between depression and resilience in older adults : a systematic review and meta-analysis", Int J Geriatr Psychiatry, 32, pp.237~246 (2017)
  31. Whitson HE, "Physical resilience : not simply the opposite of frailty", J Am Geriatr Soc, 66, pp.1459~1461 (2018)
  32. Svedberg P, "Self-rated health in a longitudinal perspective : a 9-year follow-up twin study", J Gerontol B Psychol Sci Soc Sci, 60, pp.S331~S340 (2005)
  33. Kim NH, "Weight-adjusted waist index reflects fat and muscle mass in the opposite direction in older adults", Age Ageing, 50, pp.780~786 (2021)
  34. Park Y, "A novel adiposity index as an integrated predictor of cardiometabolic disease morbidity and mortality", Sci Rep, 8, pp.16753~ (2018)
  35. Spielberger CD, "Assessment of anger : the state-trait anger expression scale", Advances in Personality Assessment, 2, pp.161~189 (1983)
  36. Chon KK, "Development of the STAXI-K : IV", Korean J Art Ther, 7, pp.33~50 (2000)
  37. Spitzer RL, "A brief measure for assessing generalized anxiety disorder : the GAD-7", Arch Intern Med, 166, pp.1092~1097 (2006)
  38. Smith BW, "The brief resilience scale : assessing the ability to bounce back", Int J Behav Med, 15, pp.194~200 (2008)
  39. Kim J, "Reliability and validity of the Korean version of the brief resilience scale", Clin Psychopharmacol Neurosci, 21, pp.732~741 (2023)
  40. Hayes AF, "Beyond Baron and Kenny : statistical mediation analysis in the new millennium", Commun Monogr, 76, pp.408~420 (2009)
  41. Novaco RW, "Perspectives on anger treatment : discussion and commentary", Cogn Behav Pract, 18, pp.251~255 (2011)
  42. Subramanyam V, "Jamuna D. Correlates of self rated health among elderly men and women from different social classes : a prospective study", Int J Multidiscip Res Anal, 5, pp.149~154 (2022)
  43. Schless AP, "Depression and hostility", J Nerv Ment Dis, 159, pp.91~100 (1974)
  44. Weissman MM, "Clinical evaluation of hostility in depression", Am J Psychiatry, 128, pp.261~266 (1971)
  45. Fukase Y, "Depression, risk factors, and coping strategies in the context of social dislocations resulting from the second wave of COVID-19 in Japan", BMC Psychiatry, 21, pp.33~ (2021)
  46. Kim AS, "Effects of self-efficacy, depression, and anger on health-promoting behaviors of korean elderly women with hypertension", Int J Environ Res Public Health, 17, pp.6296~ (2020)
  47. Park MY, "The relationship between health promoting behaviors and anger in elderly women", J Korean Acad Funda Nurs, 12, pp.354~361 (2005)
  48. Curran E, "Prevalence and factors associated with anxiety and depression in older adults : gender differences in psychosocial indicators", J Affect Disord, 267, pp.114~122 (2020)
  49. Andreescu C, "Anxiety disorders in the elderly", Adv Exp Med Biol, 1191, pp.561~576 (2020)
  50. Edward K, "Resilience : a protector from depression", J Am Psychiatr Nurses Assoc, 11, pp.241~243 (2005)
  51. Smit F, "Target groups for the prevention of late-life anxiety", Br J Psychiatry, 190, pp.428~434 (2007)
  52. Franco OH, "Changing course in ageing research : the healthy ageing phenotype", Maturitas, 63, pp.13~19 (2009)
  53. Cristea IA, "The effects of cognitive behavior therapy for adult depression on dysfunctional thinking : a meta-analysis", Clin Psychol Rev, 42, pp.62~71 (2015)
  54. Smith L, "The association of grip strength with depressive symptoms and cortisol in hair : a cross-sectional study of older adults", Scand J Med Sci Sports, 29, pp.1604~1609 (2019)

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