12 results on '"Borges, Marcus K."'
Search Results
2. Design and protocol of the multimorbidity and mental health cohort study in frailty and aging (MiMiCS-FRAIL): unraveling the clinical and molecular associations between frailty, somatic disease burden and late life depression
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Aprahamian, Ivan, Mamoni, Ronei Luciano, Cervigne, Nilva Karla, Augusto, Taize Machado, Romanini, Carla Vasconcelos, Petrella, Marina, da Costa, Daniele Lima, Lima, Natalia Almeida, Borges, Marcus K., and Oude Voshaar, Richard C.
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- 2020
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3. Frailty and affective disorders throughout adult life: A 5‐year follow‐up of the Lifelines Cohort Study
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Borges, Marcus K., primary, Jeuring, Hans W., additional, Marijnissen, Radboud M., additional, van Munster, Barbara C., additional, Aprahamian, Ivan, additional, van den Brink, Rob H. S., additional, Hoogendijk, Emiel O., additional, and Oude Voshaar, Richard C., additional
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- 2022
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4. Association of frailty with cognitive impairment and functional disability in older adults with affective disorders: a brief research report.
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Monteiro, Ariane M. and Borges, Marcus K.
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AFFECTIVE disorders ,OLDER people ,FRAIL elderly ,ANXIETY disorders ,COGNITION disorders ,FRAILTY ,PEOPLE with disabilities ,GERIATRIC Depression Scale - Abstract
Introduction: The Clinical-Functional Vulnerability Index (IVCF-20) is a validated multidimensional instrument that has been used in Brazil to evaluate functional disability in frail older adults. The main aim of this study was to assess frailty using this novel screening tool. In addition, to investigate whether frailty was associated with cognitive impairment and functional disability in older adults with affective disorders. Methods: Participants included were over 60 years old, with affective disorders (depressive or anxiety disorders), from two specialized outpatient clinics. The sample was comprised of 46 patients (30% of a total from 153). The following instruments were applied: Clock Drawing Test (CDT), Mini Mental State Examination (MMSE); Verbal Fluency Test (VFT); Pfeffer Questionnaire or Functional Assessment Questionnaire (FAQ); Katz Index; Geriatric Depression Scale (GDS-15); Geriatric Anxiety Inventory (GAI), and IVCF-20 as well as sociodemographic and clinical questionnaires. The association between the variables of interest was estimated using Spearman correlation. Results: This study found a negative correlation between frailty and cognitive decline (MMSE; rs = 0.58; p < 0.001); (VFT; rs = 0.60; p < 0.001); (CDT; rs = -0.47; p = 0.001) and a positive correlation between frailty and depressive symptoms (GDS-15; rs = 0.34; p = 0.019) as well as disability for IADLs (FAQ; rs = 0.69; p < 0.001). However, there was no statistical difference in the association between frailty and anxiety symptoms (GAI; rs = 0.24; p = 0.103) or disability for BADLs (Katz; rs = -0.02; p = 0.895). Discussion: Our data support that the associations between frailty, cognitive and functional disability are prevalent issues in Psychogeriatrics. Assessing frailty in a multidimensional context is essential using a rapid assessment frailty tool in clinical practice. [ABSTRACT FROM AUTHOR]
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- 2023
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5. The Frail Depressed Patient: A Narrative Review on Treatment Challenges
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Aprahamian,Ivan, Borges,Marcus K, Hanssen,Denise J.C., Jeuring,Hans W, and Oude Voshaar,Richard C.
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Clinical Interventions in Aging - Abstract
Ivan Aprahamian,1,2 Marcus K Borges,3 Denise J C Hanssen,2 Hans W Jeuring,2 Richard C Oude Voshaar2 1Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Geriatrics Division, Department of Internal Medicine, Jundiaà Medical School, JundiaÃ, Brazil; 2University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands; 3Federal University of Paraná, Department of Psychiatry, Curitiba, BrazilCorrespondence: Ivan Aprahamian, Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Division of Geriatrics, Department of Internal Medicine, Jundiaà Medical School, JundiaÃ, Brazil, Email ivan.aprahamian@gmail.comAbstract: 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 polypharmacy. Applying a frailty informed framework of depression treatment studies included in a meta-analysis reveals that the benefitâharm 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 antidepressants might be preferable when slowness is a prominent clinical feature. Psychotherapy is an important alternative for pharmacological 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.Keywords: frailty, depression, depressive disorder
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- 2022
6. Frailty in geriatric psychiatry inpatients: a retrospective cohort study.
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Aprahamian, Ivan, Landowski, Anne, Ahn, Fernanda O., Neves, Beatriz A., Rocha, Júlia T., Strauss, Jason, Borges, Marcus K., Morley, John E., and Oude Voshaar, Richard C.
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Objective: We aimed to evaluate the prevalence, clinical determinants, and consequences (falls and hospitalization) of frailty in older adults with mental illness.Design: Retrospective clinical cohort study.Setting: We collected the data in a specialized psychogeriatric ward, in Boston, USA, between July 2018 and June 2019.Participants: Two hundred and fourty-four inpatients aged 65 years old and over.Measurements: Psychiatric diagnosis was based on a multi-professional consensus meeting according to DSM-5 criteria. Frailty was assessed according to two common instruments, that is, the FRAIL questionnaire and the deficit accumulation model (aka Frailty Index [FI]). Multiple linear regression analyses were conducted to evaluate the association between frailty and sample demographics (age, female sex, and non-Caucasian ethnicity) and clinical characteristics (dementia, number of clinical diseases, current infection, number of psychotropic, and non-psychotropic medications in use). Multiple regression between frailty assessments and either falls or number of hospital admissions in the last 6 and 12 months, respectively, were analyzed and adjusted for covariates.Results: Prevalence of frailty was high, that is, 83.6% according to the FI and 55.3% according to the FRAIL questionnaire. Age, the number of clinical (somatic) diseases, and the number of non-psychotropic medications were independently associated with frailty identified by the FRAIL. Dementia, current infection, the number of clinical (somatic) diseases, and the number of non-psychotropic medications were independently associated with frailty according to the FI. Falls were significantly associated with both frailty instruments. However, we found only a significant association for the number of hospital admissions with the FI.Conclusion: Frailty is highly prevalent among geriatric psychiatry inpatients. The FRAIL questionnaire and the FI may capture different forms of frailty dimensions, being the former probably more associated with the phenotype model and the latter more associated with multimorbidity. [ABSTRACT FROM AUTHOR]- Published
- 2022
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7. A 6‐year prospective clinical cohort study on the bidirectional association between frailty and depressive disorder
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Oude Voshaar, Richard C., primary, Dimitriadis, Menelaos, additional, vandenBrink, Rob H. S., additional, Aprahamian, Ivan, additional, Borges, Marcus K., additional, Marijnissen, Radboud M., additional, Hoogendijk, Emiel O., additional, Rhebergen, Didi, additional, and Jeuring, Hans W., additional
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- 2021
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8. Depression as a determinant of frailty in late life
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Borges, Marcus K., primary, Aprahamian, Ivan, additional, Romanini, Carla V., additional, Oliveira, Fabiana M., additional, Mingardi, Silvana V. B., additional, Lima, Natália A., additional, Cecato, Juliana F., additional, Petrella, Marina, additional, and Oude Voshaar, Richard C., additional
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- 2020
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9. Frailty in geriatric psychiatry inpatients: a retrospective cohort study
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Aprahamian, Ivan, primary, Landowski, Anne, additional, Ahn, Fernanda O., additional, Neves, Beatriz A., additional, Rocha, Júlia T., additional, Strauss, Jason, additional, Borges, Marcus K., additional, Morley, John E., additional, and Oude Voshaar, Richard C., additional
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- 2020
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10. Depression as a determinant of frailty in late life.
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Borges, Marcus K., Aprahamian, Ivan, Romanini, Carla V., Oliveira, Fabiana M., Mingardi, Silvana V. B., Lima, Natália A., Cecato, Juliana F., Petrella, Marina, and Oude Voshaar, Richard C.
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FRAIL elderly ,MULTIPLE regression analysis ,GERIATRIC assessment ,INTERVIEWING ,REGRESSION analysis ,RISK assessment ,MENTAL depression ,QUESTIONNAIRES ,DISEASE prevalence ,DESCRIPTIVE statistics ,CLASSIFICATION of mental disorders ,LONGITUDINAL method ,OLD age - Abstract
Accumulating evidence shows depression as a risk factor for frailty, but studies are mainly population-based and widely differ in their assessment of either depression or frailty. We investigated the association between depression and frailty among geriatric outpatients using different assessment instruments for both conditions. Among 315 geriatric outpatients (mean age 72.1 years, 68.3% female sex) participating the MiMiCS-FRAIL cohort study, major and subthreshold depression were measured with psychiatric diagnostic interview according to DSM-5 criteria (SCID-5) as well as with instruments to screen and measure severity of depressive symptoms (GDS-15 and PHQ-9). Frailty was assessed according to a screening instrument (FRAIL-BR) and a multidimensional Frailty Index (FI-36 items). Multiple logistic and linear regression were performed to assess the association between depression (independent variable) and frailty (dependent variable) adjusted for confounders. Frailty prevalence in patients with no, subthreshold or major depressive disorder increases from either 14.5%, 46.5% to 65.1% when using the FRAIL-BR questionnaire, and from 10.2%, 20.9%, to 30.2% when using the FI-36 index. These association remain nearly the same when adjusted for covariates. Both the FRAIL-BR and the FI-36 were strongly associated with major depressive disorder, subthreshold depression, and depressive symptoms by PHQ-9 and GDS-15. Late life depression and frailty are associated in a dose-dependent manner, irrespective of the used definitions. Nonetheless, to avoid residual confounding, future research on underlying biological mechanisms should preferably be based on formal psychiatric diagnoses and objectively assessment frailty status. [ABSTRACT FROM AUTHOR]
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- 2021
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11. Serotonin receptor inhibitor is associated with falls independent of frailty in older adults
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Lin, Sumika M., primary, Borges, Marcus K., additional, de Siqueira, Alaise S. S., additional, Biella, Marina M., additional, Jacob-Filho, Wilson, additional, Cesari, Matteo, additional, Voshaar, Richard C. Oude, additional, and Aprahamian, Ivan, additional
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- 2019
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12. Serotonin receptor inhibitor is associated with falls independent of frailty in older adults.
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Lin, Sumika M., Borges, Marcus K., de Siqueira, Alaise S. S., Biella, Marina M., Jacob-Filho, Wilson, Cesari, Matteo, Voshaar, Richard C. Oude, and Aprahamian, Ivan
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CELL receptors ,FRAIL elderly ,LONGITUDINAL method ,SEROTONIN - Abstract
To evaluate whether fall risk in older adults is associated with the use of selective serotonin receptor inhibitor (SSRI) monotherapy among geriatric outpatients, and whether this association is moderated by the presence of depressive disorder and/or frailty. Prospective cohort study with a 12-month follow-up and including 811 community-dwelling adults aged 60 or older from a university-based Geriatric Outpatient Unit. Major depressive disorder (MDD) was diagnosed according to DSM-5 criteria; subsyndromal depression as not meeting MDD criteria, but a Geriatric Depression Scale 15-item score ≥ 6 points. Frailty was evaluated with the FRAIL questionnaire. The association between SSRI use, depression, or both as well as the association between SSRI use, frailty, or both with falls were estimated through a generalized estimating equation (GEE) adjusted for relevant confounders. At baseline, 297 patients (36.6%) used a SSRI (82 without remitted depression) and 306 (37.7%) were classified as physically frail. Frailty was more prevalent among SSRI users (44.8% versus 33.7%, p =.004). After 12 months, 179 participants had at least one fall (22.1%). SSRI use, depression as well as frailty were all independently associated with falls during follow-up. Nonetheless, patients with concurrent of SSRI usage and non-remitted depression had no higher risk compared to either remitted SSRI users or depressed patients without SSRIs. In contrast, concurrence of SSRI use and frailty increases the risk of falling substantially above those by SSRI usage or frailty alone. SSRI usage was independently associated with falls. Especially in frail-depressed patients, treatment strategies for depression other than SSRIs should be considered. [ABSTRACT FROM AUTHOR]
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- 2021
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