title: Changes in Frailty Status and Risk of Depression: Results From the Progetto Veneto Anziani Longitudinal Study.
abstract: OBJECTIVE
  To evaluate whether prefrailty was associated with the risk of developing depression and if longitudinal changes in frailty status corresponded to changes in incident depression during follow up.
  
  
  METHODS
  A population-based, prospective cohort study was conducted for 4.4 years in two separate geographic areas near the city of Padua in the Veneto Region of Northern Italy. In 891 nondepressed, nonfrail, community-dwelling Italian subjects aged ≥ 65 (46.6% men) belonging to the Progetto Veneto Anziani study, depression was defined according to the Geriatric Depression Scale and was confirmed by geriatricians skilled in psychogeriatric medicine. Prefrailty was defined by the presence of one or two criteria among the Fried criteria.
  
  
  RESULTS
  The incidence rate of depression was 13.3% among subjects improving their frailty status at follow-up (N = 15), 15.0% in those who remained stable (N = 79), and 26.7% among worsening participants (N = 67) (p = 0.001). Prefrailty at baseline did not predict the onset of depression (HR: 0.82; 95% CI: 0.55-1.21; Wald χ2= 0.73; df = 1; p = 0.43), but a deterioration during follow-up in at least one additional frailty criteria was associated with a significantly higher risk (HR: 1.95; 95% CI: 1.32-2.89; Wald χ2= 5.78; df = 2; p = 0.01). Improvement in frailty status was not associated with the risk of incident depression (HR: 0.71; 95% CI: 0.35-1.42; Wald χ2= 0.47; df = 2; p = 0.28).
  
  
  CONCLUSIONS
  Our data did not offer evidence that prefrailty per se predisposes to the onset of depression, but worsening in frailty status is associated with an almost twofold increased risk of incident depression, irrespective from the initial level of impairment.
authors.affiliation: Department of Medicine DIMED, Geriatrics Division, University of Padova, Padova, Italy. Electronic address: marinaderui@gmail.com.
authors.forename: Marina
authors.initials: M
authors.lastname: De Rui
authors.affiliation: Department of Medicine DIMED, Geriatrics Division, University of Padova, Padova, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Veronese
authors.affiliation: Department of Medicine DIMED, Geriatrics Division, University of Padova, Padova, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Trevisan
authors.affiliation: Department of Medicine DIMED, Geriatrics Division, University of Padova, Padova, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Carraro
authors.affiliation: Department of Medicine DIMED, Geriatrics Division, University of Padova, Padova, Italy.
authors.forename: Linda
authors.initials: L
authors.lastname: Berton
authors.affiliation: National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Maggi
authors.affiliation: Department of Medicine DIMED, Clinica Medica I, University of Padova, Padova, Italy.
authors.forename: Sabina
authors.initials: S
authors.lastname: Zambon
authors.affiliation: Division of Health Care Planning and Evaluation of the Regione Veneto, Venice, Italy.
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Corti
authors.affiliation: Internal Medicine Division, Azienda Ospedaliera, Padova, Italy.
authors.forename: Giovannella
authors.initials: G
authors.lastname: Baggio
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy.
authors.forename: Egle
authors.initials: E
authors.lastname: Perissinotto
authors.affiliation: National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Crepaldi
authors.affiliation: Division of Health Care Planning and Evaluation of the Regione Veneto, Venice, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
authors.affiliation: Department of Medicine DIMED, Geriatrics Division, University of Padova, Padova, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sergi
mesh_terms: D000368:Aged; D003863:Depression / Q000453:epidemiology*; D005260:Female; D016330:Frail Elderly / Q000523:psychology* / Q000706:statistics & numerical data*; D000073496:Frailty / Q000453:epidemiology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment
keywords: Frailty; aging; depression; elderly; prefrailty