Clinical Investigations

Antidepressant Use, Depressive Symptoms, and Incident Frailty in Women Aged 65 and Older from the Women's Health Initiative Observational Study

  1. Susan L. Lakey PharmD, MPH1,*,
  2. Andrea Z. LaCroix PhD2,
  3. Shelly L. Gray PharmD, MS3,
  4. Soo Borson MD4,
  5. Carla D. Williams PhD5,
  6. Darren Calhoun PhD6,
  7. Joseph S. Goveas MD7,
  8. Jordan W. Smoller MD, ScD8,
  9. Judith K. Ockene PhD9,
  10. Kamal H. Masaki MD10,
  11. Mace Coday PhD11,
  12. Milagros C. Rosal PhD9,
  13. Nancy F. Woods PhD12

Article first published online: 9 MAY 2012

DOI: 10.1111/j.1532-5415.2012.03940.x

Issue

Journal of the American Geriatrics Society

Journal of the American Geriatrics Society

Volume 60, Issue 5, pages 854–861, May 2012

Additional Information

How to Cite

Lakey, S. L., LaCroix, A. Z., Gray, S. L., Borson, S., Williams, C. D., Calhoun, D., Goveas, J. S., Smoller, J. W., Ockene, J. K., Masaki, K. H., Coday, M., Rosal, M. C. and Woods, N. F. (2012), Antidepressant Use, Depressive Symptoms, and Incident Frailty in Women Aged 65 and Older from the Women's Health Initiative Observational Study. Journal of the American Geriatrics Society, 60: 854–861. doi: 10.1111/j.1532-5415.2012.03940.x

Author Information

  1. 1

    Group Health Research Institute, Seattle, Washingtin

  2. 2

    Women's Health Initiative Clinical Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, Washingtin

  3. 3

    School of Pharmacy, University of Washington, Seattle, Washingtin

  4. 4

    Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, Washington;

  5. 5

    Howard University Cancer Center, Washington, District of Columbia;

  6. 6

    MedStar Research Institute, Phoenix, Arizona;

  7. 7

    Department of Psychiatry, Medical College of Wisconsin, Milwaukee, Wisconsin;

  8. 8

    Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts;

  9. 9

    Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts;

  10. 10

    Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii;

  11. 11

    Department of Preventative Medicine and Psychiatry, University of Tennessee Health Science Center, Memphis, Tennessee

  12. 12

    Department of Biobehavioral Nursing, School of Nursing, University of Washington, Seattle, Washington

*Address correspondence to Susan L. Lakey, University of Washington School of Pharmacy, Department of Pharmacy, Box 357630, Seattle, WA 98195. E-mail: slakey@uw.edu

  1. Data were presented, in part, at the Gerontological Society of America 62nd Annual Scientific Meeting, Atlanta, Georgia, November 18–22, 2009.

Publication History

  1. Issue published online: 15 MAY 2012
  2. Article first published online: 9 MAY 2012

Funded by

  • National Heart, Lung, and Blood Institute
  • National Institutes of Health
  • U.S. Department of Health and Human Services. Grant Numbers: N01WH22110, 42107–26, 42129–32, 44221, T32 AG027677, 24152, 32100–2, 32105–6, 32108–9, 32111–13, 32115, 32118–32119, 32122
  • National Institute of Aging

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Keywords:

  • antidepressant use;
  • frailty;
  • depression;
  • Women's Health Initiative

Objectives

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.

Design

Secondary analysis of the Women's Health Initiative Observational Study (WHI-OS), a prospective cohort study.

Setting

WHI-OS was conducted in 40 U.S. clinical centers.

Participants

Women aged 65 to 79, not frail at baseline.

Measurements

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).

Conclusion

In older adult women, depressive symptoms and antidepressant use were associated with frailty after 3 years of follow-up.

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