Evidence map›Paper›PMID 33388223›Full record

ArticleThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2021

Frailty Worsens Antidepressant Treatment Outcomes in Late Life Depression.

Patrick J Brown, Adam Ciarleglio, Steven P Roose, Carolina Montes Garcia, Sarah Chung, Johana Alvarez, Alexandra Stein, Stephanie Gomez, Bret R Rutherford

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01973283 (Antidepressant Response in the Treatment of Depressive Symptoms and Frailty Characteristics in Older Adults), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01973283 phase4completednot on this map

Antidepressant Response in the Treatment of Depressive Symptoms and Frailty Characteristics in Older Adults

TypeinterventionalSponsorNew York State Psychiatric InstituteRan2014 to 2020Enrolled100ConditionsMajor Depressive Disorder, Dysthymic Disorder, Depressive Disorder, NOSArmsAntidepressant Medication
3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Patrick J BrownNew York State Psychiatric Institute, Columbia University College of Physicians and Surgeons (PJB, SPR, CMG, JA, AS, SG, BRR), New York, NY. Electronic address: pb2410@cumc.columbia.edu.
Adam CiarleglioDepartment of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University (AC), Washington, DC.
Steven P RooseNew York State Psychiatric Institute, Columbia University College of Physicians and Surgeons (PJB, SPR, CMG, JA, AS, SG, BRR), New York, NY.
Carolina Montes GarciaNew York State Psychiatric Institute, Columbia University College of Physicians and Surgeons (PJB, SPR, CMG, JA, AS, SG, BRR), New York, NY.
Sarah ChungAlbert Einstein College of Medicine (SC), New York, NY.
Johana AlvarezNew York State Psychiatric Institute, Columbia University College of Physicians and Surgeons (PJB, SPR, CMG, JA, AS, SG, BRR), New York, NY.
Alexandra SteinNew York State Psychiatric Institute, Columbia University College of Physicians and Surgeons (PJB, SPR, CMG, JA, AS, SG, BRR), New York, NY.
Stephanie GomezNew York State Psychiatric Institute, Columbia University College of Physicians and Surgeons (PJB, SPR, CMG, JA, AS, SG, BRR), New York, NY.
Bret R RutherfordNew York State Psychiatric Institute, Columbia University College of Physicians and Surgeons (PJB, SPR, CMG, JA, AS, SG, BRR), New York, NY.
Columbia University · USAlbert Einstein College of Medicine · USGeorge Washington University · US

Funding

Mechanisms of Antidepressant Non-Response in Late-Life DepressionR01MH102293 · NIMH · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI RUTHERFORD, BRET R · 2014 to 2018
$2.0M
The Phenomenology and Antidepressant Treatment of Depressed, Frail Older AdultsK23MH099097 · NIMH · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI BROWN, PATRICK J · 2013 to 2017
$850k
Statistical and Machine Learning Methods for Integrating Clinical and Multimodal Imaging Data to Select Optimal Antidepressant TreatmentK01MH113850 · NIMH · GEORGE WASHINGTON UNIVERSITY · PI CIARLEGLIO, ADAM · 2018 to 2021
$647k
NIMH NIH HHS K01 MH113850NIMH NIH HHS K23 MH099097NIMH NIH HHS R01 MH102293
6 · The paper itself

Abstract

objectiveTo investigate the relationship between frailty and treatment response to antidepressant medications in adults with late life depression (LLD).

methodsData were evaluated from 100 individuals over age 60 years (34 men, 66 women) with a depressive diagnosis, who were assessed for frailty at baseline (characteristics include gait speed, grip strength, activity levels, fatigue, and weight loss) and enrolled in an 8-week trial of antidepressant medication followed by 10 months of open-treatment.

resultsFrail individuals (n = 49 with ≥3 deficits in frailty characteristics) did not differ at baseline from the non/intermediate frail (n = 51 with 0-2 deficits) on demographic, medical comorbidity, cognitive, or depression variables. On average, frail individuals experienced 2.82 fewer Hamilton Rating Scale for Depression (HRSD) points of improvement (t = 2.12, df 89, p = 0.037) than the non/intermediate frail over acute treatment, with this difference persisting over 10 months of open-treatment. Weak grip strength and low physical activity levels were each associated with decreased HRSD improvement, and lower response and remission rates over the course of the study. Despite their poorer outcomes, frail individuals received more antidepressant medication trials than the non/intermediate frail.

conclusionAdults with LLD and frailty have an attenuated response to antidepressant medication and a greater degree of disability compared to non/intermediate frail individuals. This disability and attenuated response remain even after receiving a greater number of antidepressant medication trials. Future research must focus on understanding the specific pathophysiology associated with the frail-depressed phenotype to permit the design and implementation of precision medicine interventions for this high-risk population.

Indexed as

FrailtyAgedAntidepressive AgentsDepressionFemaleFrail ElderlyHumansMaleTreatment OutcomeAntidepressive Agentsantidepressant medicationsdisabilityFrailtygrip strengthlate life depression

Identifiers

PMID33388223
PMCPMC8225710
OpenAlexW3115387778

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.