Association Between Cognitive Impairment, Functional Decline and Frailty in Older Adults with Affective Disorders: Insights into Geriatric vulnerability

OBJECTIVES: The relationship between affective disorders and frailty in older adults remains underexplored, despite their impact on quality of life and healthcare costs. This study aimed to investigate the relationship between affective symptoms, cognitive impairment, functional decline and frailty. METHODS: A cross-sectional study was conducted with 153 patients aged ≥60 years from two Psychogeriatric outpatient clinics. Standardized tools were used, including the Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), Verbal Fluency Test (VFT), Pfeffer Questionnaire and Katz Index (to assess functional decline), Geriatric Depression Scale (GDS-15), Geriatric Anxiety Inventory (GAI), and a clinical-sociodemographic questionnaire. Spearman correlations and Poisson regression were performed. RESULTS: Frailty prevalence was 62.1, and significant associations were found between frailty and depressive symptoms on GDS-15 (OR = 6.74), cognitive impairment on VFT (OR = 2.80), CDT (OR = 4.33), MMSE (OR = 4.88) and functional disability on Pfeffer (OR = 14.95). Multivariate analysis identified polypharmacy (OR = 1.64), depressive symptoms (OR = 1.97), cognitive impairment in VFT (OR = 1.30), and functional disability in Pfeffer (OR = 1.96) as independent predictors of frailty. CONCLUSIONS: These findings reinforce the association between affective disorders, cognitive impairment, functional decline and frailty in older adults. CLINICAL IMPLICATIONS: The use of integrated tools can help identify patients at greater risk of frailty, guiding multidisciplinary interventions in geriatric mental health.