title: Physical frailty: vulnerability of patients suffering from late-life depression.
abstract: OBJECTIVE
  Frailty, a state of increased risk of negative health outcomes, is increasingly recognized as a relevant concept for identifying older persons in need of preventative geriatric interventions. Even though broader concepts of frailty include psychological characteristics, frailty is largely neglected in mental health care. The aim of the present study is to examine the prevalence of physical frailty in depressed older patients and its potential overlap with depression criteria.
  
  
  METHODS
  Cross-sectional observational study including 378 depressed and 132 non-depressed adults aged ≥60 years according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Physical frailty was defined as ≥3 out of 5 criteria (handgrip strength, weight loss, poor endurance, walking speed, low physical activity).
  
  
  RESULTS
  Prevalence rates of physical frailty were 27.2% and 9.1% among depressed and non-depressed participants, respectively, which remained significant after controlling for relevant covariates (odds ratio [OR] = 2.66 [95% confidence interval [C.I.] = 1.36, 5.24], p = .004). Physical frailty in depression was associated with more severe depressive symptoms; this association remained significant in subsequent analyses with purely physical proxies for frailty (hand grip strength, walking speed) and different severity measures of depressive symptoms.
  
  
  CONCLUSIONS
  A quarter of depressed older patients is physically frail, especially the most depressed group. This cannot be explained by overlap in criteria and should be examined in future studies, primarily on its presumed clinical relevance.
authors.affiliation: a Department of Psychiatry , University Medical Centre St. Radboud , Nijmegen , The Netherlands.
authors.forename: Rose M
authors.initials: RM
authors.lastname: Collard
authors.forename: Hannie C
authors.initials: HC
authors.lastname: Comijs
authors.forename: Paul
authors.initials: P
authors.lastname: Naarding
authors.forename: Richard C
authors.initials: RC
authors.lastname: Oude Voshaar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D016330:Frail Elderly / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors
keywords: Netherlands Study of Depression in Older persons (NESDO); depression; elderly; frailty