title: Antidepressant use, depressive symptoms, and incident frailty in women aged 65 and older from the Women's Health Initiative Observational Study.
abstract: OBJECTIVE
  To examine the associations between depressive symptoms, antidepressant use, and duration of use with incident frailty 3 years later in nonfrail women aged 65 and older.
  
  
  METHODS
  Secondary analysis of the Women's Health Initiative Observational Study (WHI-OS), a prospective cohort study.
  
  
  METHODS
  WHI-OS was conducted in 40 U.S. clinical centers.
  
  
  METHODS
  Women aged 65 to 79, not frail at baseline.
  
  
  METHODS
  Antidepressant use was assessed through medication container inspection at baseline. Four groups were created according to baseline use and Burnam depression screen (range 0-1, 0.06 cutoff): antidepressant nonusers without depressive symptoms (reference group), antidepressant nonusers with depressive symptoms, antidepressant users without depressive symptoms, and antidepressant users with depressive symptoms. Frailty components included slowness or weakness, exhaustion, low physical activity, and unintended weight loss, ascertained through self-report and physical measurements at baseline and Year 3.
  
  
  RESULTS
  Of 27,652 women at baseline, 1,350 (4.9%) were antidepressant users and 1,794 (6.5%) were categorized as depressed. At Year 3, 4,125 (14.9%) were frail. All groups had a greater risk of incident frailty than the reference group. Odds ratios (ORs) ranged from 1.73 (95% confidence interval (CI) = 1.41-2.12) in antidepressant users who were not depressed to 3.63 in antidepressant users who were depressed (95% CI = 2.37-5.55). All durations of use were associated with incident frailty (<1 year OR = 1.95, 95% CI = 1.41-2.68; 1-3 years OR = 1.99, 95% CI = 1.45-2.74; >3 years OR = 1.60, 95% CI = 1.20-2.14).
  
  
  CONCLUSIONS
  In older adult women, depressive symptoms and antidepressant use were associated with frailty after 3 years of follow-up.
authors.affiliation: Group Health Research Institute, Seattle, Washingtin, USA. slakey@uw.edu
authors.forename: Susan L
authors.initials: SL
authors.lastname: Lakey
authors.forename: Andrea Z
authors.initials: AZ
authors.lastname: LaCroix
authors.forename: Shelly L
authors.initials: SL
authors.lastname: Gray
authors.forename: Soo
authors.initials: S
authors.lastname: Borson
authors.forename: Carla D
authors.initials: CD
authors.lastname: Williams
authors.forename: Darren
authors.initials: D
authors.lastname: Calhoun
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Goveas
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Smoller
authors.forename: Judith K
authors.initials: JK
authors.lastname: Ockene
authors.forename: Kamal H
authors.initials: KH
authors.lastname: Masaki
authors.forename: Mace
authors.initials: M
authors.lastname: Coday
authors.forename: Milagros C
authors.initials: MC
authors.lastname: Rosal
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Woods
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D016387:Women's Health
chemical_list: D000928:Antidepressive Agents