共 94 条
The Frail Depressed Patient: A Narrative Review on Treatment
被引:11
作者:

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Borges, Marcus K.
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Fed Parana, Dept Psychiat, Curitiba, Parana, Brazil Jundiai Med Sch, Grp Invest Multimorbid & Mental Hlth Aging GIMMA, Dept Internal Med, Geriatr Div, Jundiai, Brazil

Hanssen, Denise J. C.
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Groningen, Univ Med Ctr Groningen, Dept Psychiat, Groningen, Netherlands Jundiai Med Sch, Grp Invest Multimorbid & Mental Hlth Aging GIMMA, Dept Internal Med, Geriatr Div, Jundiai, Brazil

Jeuring, Hans W.
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Groningen, Univ Med Ctr Groningen, Dept Psychiat, Groningen, Netherlands Jundiai Med Sch, Grp Invest Multimorbid & Mental Hlth Aging GIMMA, Dept Internal Med, Geriatr Div, Jundiai, Brazil

Voshaar, Richard C. Oude
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Groningen, Univ Med Ctr Groningen, Dept Psychiat, Groningen, Netherlands Jundiai Med Sch, Grp Invest Multimorbid & Mental Hlth Aging GIMMA, Dept Internal Med, Geriatr Div, Jundiai, Brazil
机构:
[1] Jundiai Med Sch, Grp Invest Multimorbid & Mental Hlth Aging GIMMA, Dept Internal Med, Geriatr Div, Jundiai, Brazil
[2] Univ Groningen, Univ Med Ctr Groningen, Dept Psychiat, Groningen, Netherlands
[3] Univ Fed Parana, Dept Psychiat, Curitiba, Parana, Brazil
关键词:
frailty;
depression;
depressive disorder;
MINDFULNESS-BASED INTERVENTIONS;
COGNITIVE-BEHAVIORAL THERAPY;
LATE-LIFE DEPRESSION;
OLDER-ADULTS;
COMMITMENT THERAPY;
PHYSICAL-ACTIVITY;
DOUBLE-BLIND;
METAANALYSIS;
ACCEPTANCE;
COMMUNITY;
D O I:
10.2147/CIA.S328432
中图分类号:
R592 [老年病学];
C [社会科学总论];
学科分类号:
03 ;
0303 ;
100203 ;
摘要:
Although the public importance of frailty is widely acknowledged by the World Health Organization, physical frailty is still largely neglected in geriatric mental health care. Firstly in this narrative review, we summarize the knowledge on the epidemiology of the association between depression and frailty, whereafter implications for treatment will be discussed. Even though frailty and depression have overlapping diagnostic criteria, epidemiological studies provide evidence for distinct constructs which are bidirectionally associated. Among depressed patients, frailty has predictive validity being associated with increased mortality rates and an exponentially higher fall risk due to antidepressants. Nonetheless, guidelines on the treatment of depression neither consider frailty for risk stratification nor for treatment selection. We argue that frailty assessment enables clinicians to better target the pharmacological and psychological treatment of depression as well as the need for interventions targeting primarily frailty, for instance, lifestyle interventions and reduction of poly -pharmacy. Applying a frailty informed framework of depression treatment studies included in a meta-analysis reveals that the benefit???harm ratio of antidepressants given to frail depressed patients can be questioned. Nonetheless, frail-depressed patients should not withhold antidepressants as formal studies are not available yet, but potential adverse effects should be closely monitored. Dopaminergic anti-depressants might be preferable when slowness is a prominent clinical feature. Psychotherapy is an important alternative for pharmacolo-gical treatment, especially psychotherapeutic approaches within the movement of positive psychology, but this approach needs further study. Finally, geriatric rehabilitation, including physical exercise and nutritional advice, should also be considered. In this regard, targeting ageing -related abnormalities underlying frailty that may also be involved in late-life depression such as low-grade inflammation might be a promising target for future studies. The lack of treatment studies precludes firm recommendations, but more awareness for frailty in mental health care will open a plethora of alternative treatment options to be considered.
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页码:979 / 990
页数:12
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Stein, Alexandra
;
Gomez, Stephanie
;
Rutherford, Bret R.
.
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY,
2021, 29 (09)
:944-955

Brown, Patrick J.
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机构:
Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA

Ciarleglio, Adam
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机构:
George Washington Univ, Milken Inst Sch Publ Hlth, Dept Biostat & Bioinformat, Washington, DC USA Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA

Roose, Steven P.
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Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA

Garcia, Carolina Montes
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Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA

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Alvarez, Johana
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机构:
Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA

Stein, Alexandra
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机构:
Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA

Gomez, Stephanie
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h-index: 0
机构:
Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA

Rutherford, Bret R.
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h-index: 0
机构:
Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA Columbia Univ Coll Phys & Surg, New York State Psychiat Inst, New York, NY USA