Close Correlation between Frailty and Depressive State in Chronic Liver Diseases

• Main Authors: Hiroki Nishikawa, Kazunori Yoh, Hirayuki Enomoto, Yoshinori Iwata, Yoshiyuki Sakai, Kyohei Kishino, Yoshihiro Shimono, Naoto Ikeda, Tomoyuki Takashima, Nobuhiro Aizawa, Ryo Takata, Kunihiro Hasegawa, Takashi Koriyama, Yukihisa Yuri, Takashi Nishimura, Shuhei Nishiguchi, Hiroko Iijima
• Format: Article
• Language: English
• Published: MDPI AG 2020-06-01
• Series: Medicina
• Subjects: chronic liver disease; frailty; depression; physiological aspects; psychological aspects
• Online Access: https://www.mdpi.com/1010-660X/56/7/319

Background and objectives: Few data with regard to the relevance between depression and frailty in chronic liver disease (CLD) patients are currently available. We aimed to elucidate the relationship between frailty and depression as evaluated by the Beck Depression Inventory—2nd edition (BDI-II) in CLD patients (<i>n</i> = 340, median age = 65.0 years). Methods: Frailty was defined as a clinical syndrome in which three or more of the following criteria were met: body weight loss, exhaustion, muscle weakness, slow walking speed and low physical activity. Depressive state was defined as BDI-II score 11 or greater. Results: Robust (frailty score = zero), prefrail (frailty score = one or two) and frailty were identified in 114 (33.5%), 182 (53.5%) and 44 (12.9%). The median BDI-II score was five. Depressive state was identified in 84 patients (24.7%). The median BDI-II scores in patients with robust, prefrail and frail traits were 2, 7 and 12.5 (robust vs. prefrail, <i>p</i> < 0.0001; prefrail vs. robust, <i>p</i> = 0.0003; robust vs. frail, <i>p</i> < 0.0001; overall <i>p</i> < 0.0001). The proportions of depressive state in patients with robust, prefrail and frail traits were 3.51%, 30.77% and 54.55% (robust vs. prefrail, <i>p</i> < 0.0001; prefrail vs. robust, <i>p</i> = 0.0046; robust vs. frail, <i>p</i> < 0.0001; overall <i>p</i> < 0.0001). BDI-II score significantly correlated with frailty score (<i>r_s</i> = 0.5855, <i>p</i> < 0.0001). Conclusions: The close correlation between frailty and depression can be found in CLD. Preventing frailty in CLD should be approached both physiologically and psychologically.