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CompletedNCT01973283Updated Jan 29, 2021Results posted

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

A Phase 4 interventional study of Antidepressant Medication in Major Depressive Disorder, Dysthymic Disorder and Depressive Disorder, NOS, sponsored by New York State Psychiatric Institute. Completed at 1 site in United States. Open to participants aged 60 Years to 95 Years. Per ClinicalTrials.gov, last updated 2021-01-29.

Sponsored by New York State Psychiatric Institute · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
100
Allocation
Not applicable
Ages
60 Years to 95 Years
Sex
All
01

Study summary

The goal of this open-administration treatment study of citalopram (or duloxetine) is to evaluate the effect of antidepressant medication on treating the syndrome of "frailty" in older adults with depressive symptoms. Patients with significant depressive symptoms (defined as CES-D (Center for Epidemiological Studies - Depression scale) > 10) and 1 or more symptoms of the frailty syndrome (exhaustion, decreased energy, weight loss, decreased grip strength, and slow/unsteady gait) will be evaluated and treated with citalopram (or duloxetine) for 8 weeks to test whether antidepressant medication improves both the syndrome of frailty and depressive symptoms. Patients evaluated at the Adult and Late Life Depression clinic and eligible to participate in the study will be treated with an antidepressant medication and assessed on the primary outcome variables (characteristics of frailty, depressive symptoms) as well as on secondary variables which include cognition (global cognition, episodic memory, executive function), and function (physical mobility, instrumental activities of daily living, and social functioning) prior to treatment initiation and following 8-weeks of treatment. The hypotheses for this protocol predict that we will discover a significant improvement on both frailty characteristics and depressive symptoms in this clinical population when treated with antidepressant medication (citalopram or duloxetine).

Read the detailed description

Frailty, "a syndrome of decreased resiliency and reserves", is defined by five characteristics: 1)"shrinking" (definition: unintentional weight loss of > 10 lbs in prior year, or > 5% loss of body weight in prior year at follow-up), 2) weakness (definition: grip strength in lowest 20% at baseline, adjusted for gender and BMI), 3) poor endurance/energy (definition: self-report of exhaustion on 2 items on the CES-D), 4) slowness (definition: slowest 20% on timed 4 meter or 15 foot walk, adjusted for gender and standing height), and 5) low physical activity (definition: weighted score of kilocalories expended per week as calculated from the Minnesota Leisure Time Activity questionnaire). Frailty is associated with poor prognosis including hospitalization, falls, worsening disability and mobility, and death.

Data from the Cardiovascular Health Study document the rate of comorbid depressive symptoms in frail older adults (16.2% of older adults with at least 1 frailty characteristic had a CES-D > 10, including 31% of older adults with 3 or more frailty characteristics, compared to 2.6% of nonfrail older adults) despite study exclusion of individuals who were taking an antidepressant (this is in part why we chose to include patients with a CES-D of > 10, rather than requiring a diagnosis of a depressive disorder such as major depression or dysthymia for this study). The relationship between frailty and depression however goes beyond this association; the five defining characteristics of frailty (exhaustion, decreased energy, weight loss, decreased grip strength, and slow/unsteady gait) overlap significantly with symptoms of geriatric depression (decreased energy and motivation, psychomotor slowing, weight loss, decreased participation in leisure activities).

The proposed study is innovative in that it is focuses on a group of older adults who have been unrepresented (via exclusion criteria) in previous clinical studies (frail older adults with comorbid depressive symptoms), and it treats the comorbid depressive symptoms and targets characteristics of the frailty syndrome in the hopes of altering the prognostic trajectory of this clinical sample. This protocol serves two purposes: 1. It tests the feasibility of recruiting and retaining frail older adults with depressive symptoms in a treatment trial, and 2. It provides pilot data for the effectiveness of an antidepressant medication on treating the characteristics of frailty and the comorbid depressive symptoms.

02

Conditions studied

  • Major Depressive Disorder
  • Dysthymic Disorder
  • Depressive Disorder, NOS
03

In context

Frailty

1,198 studies on the registry are indexed under Frailty; 429 are open to participants now.

This study's enrollment of 100 is above the median of 80 across 680 interventional studies indexed under Frailty.

Browse Frailty studies →

Lead sponsor

New York State Psychiatric Institute is the lead sponsor of 425 studies on the registry; 26 are open to participants now.

Of its 50 completed or terminated interventional studies of FDA-regulated products, 45 (90%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
60 Years to 95 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Anyone with 1 or more characteristics of frailty
  • HRSD>16 and a DSM-IV depressive disorder (e.g. MDD, Dysthymia)
  • Capable of providing informed consent
  • Currently followed by a PCP (had an eval in last 6-months)

Exclusion criteria

Exclusion Criteria:

  • Acute cancer treatment
  • Acute, severe or unstable medical illness
  • End stage medical illness (e.g. liver, kidney, pulmonary)
  • Mini Mental Exam \< 24 or a diagnosis of dementia
  • Individuals who do not have capacity to consent
  • Diagnosis of substance abuse or dependence (last 12 months), excluding Nicotine dependence
  • History of psychosis or psychotic disorder or bipolar disorder
  • Patient is considered a significant risk of suicide
  • Subject is considered based on history to be unlikely to respond to the single agent antidepressant (i.e., subjects with treatment resistant depression, including subjects with previous treatment with ECT)
  • History of allergic or adverse reaction to escitalopram or duloxetine, or non-response to adequate trial of escitalopram (at least 4 weeks at dose of 20 mg) or duloxetine (at least 4 weeks at dose of 90mg).
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
100 participants (actual)

Study arms

  • Experimental
    Medication Treatment

    Participants are treated with a flexible-dose antidepressant medication for a period of 8 weeks.

    Drug: Antidepressant Medication

Interventions

  • DrugAntidepressant Medication

    If patient has a history of non-response or cannot tolerate escitalopram and/or duloxetine, then they will be treated openly with an approved antidepressant.

    Also known as: Escitalopram, Duloxetine, Open treatment

06

What researchers measure

Primary outcomes

  1. Hamilton Rating Scale for Depression (HRSD)

    Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

    Time frame: Week 8

  2. Hamilton Rating Scale for Depression (HRSD)

    Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

    Time frame: 6 Months

  3. Hamilton Depression Rating Scale (HRSD)

    Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

    Time frame: 12 Months

  4. Hamilton Depression Rating Scale: Stratified by Baseline Frailty

    Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

    Time frame: Baseline (Week 0)

  5. Hamilton Depression Rating Scale: Stratified by Baseline Frailty

    Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

    Time frame: Week 8

  6. Hamilton Depression Rating Scale: Stratified by Baseline Frailty

    Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

    Time frame: Month 6

  7. Hamilton Depression Rating Scale: Stratified by Baseline Frailty

    Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

    Time frame: Month 12

Secondary outcomes

  1. World Health Organization Disability Assessment 2.0 (36-item)

    Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

    Time frame: Baseline (Week 0)

  2. World Health Organization Disability Assessment 2.0 (36-item)

    Assesses the level of functioning of patients, a component of the frailty evaluation. Simple: the scores assigned to each of the items - "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. This method is referred to as simple scoring because the scores from each of the items are simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. This approach is practical to use as a hand-scoring approach and may be the method of choice in busy clinical settings or in paper-pencil interview situations. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

    Time frame: Week 8

  3. World Health Organization Disability Assessment 2.0 (36-item)

    Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

    Time frame: 6 Months

  4. World Health Organization Disability Assessment 2.0 (36-item)

    Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

    Time frame: 12 Months

  5. World Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty

    Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

    Time frame: Baseline (Week 0)

  6. World Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty

    Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

    Time frame: Week 8

  7. World Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty

    Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

    Time frame: Month 6

  8. World Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty

    Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

    Time frame: Month 12

07

Results

Posted Jan 13, 2021

Participant flow

Participant flow — Overall Study
MilestoneMedication Treatment-8 Weeks
Started100
Completed96
Not completed4
Withdrew: Lost to follow-up4

Outcome measures

PrimaryHamilton Rating Scale for Depression (HRSD)

Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

Time frame:
Week 8
Reported as:
Mean · score on a scale
Hamilton Rating Scale for Depression (HRSD)
score on a scaleMedication Treatment
Hamilton Rating Scale for Depression (HRSD)13.3 ± 7.90
PrimaryHamilton Rating Scale for Depression (HRSD)

Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

Time frame:
6 Months
Reported as:
Mean · score on a scale
Hamilton Rating Scale for Depression (HRSD)
score on a scaleMedication Treatment
Hamilton Rating Scale for Depression (HRSD)12.5 ± 7.44
PrimaryHamilton Depression Rating Scale (HRSD)

Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

Time frame:
12 Months
Reported as:
Mean · score on a scale
Hamilton Depression Rating Scale (HRSD)
score on a scaleMedication Treatment
Hamilton Depression Rating Scale (HRSD)13.6 ± 7.48
PrimaryHamilton Depression Rating Scale: Stratified by Baseline Frailty

Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

Time frame:
Baseline (Week 0)
Reported as:
Mean · score on a scale
Hamilton Depression Rating Scale: Stratified by Baseline Frailty
score on a scaleFrailNot/Intermediate Frail
Hamilton Depression Rating Scale: Stratified by Baseline Frailty21 ± 6.6119.7 ± 5.73
PrimaryHamilton Depression Rating Scale: Stratified by Baseline Frailty

Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

Time frame:
Week 8
Reported as:
Mean · score on a scale
Hamilton Depression Rating Scale: Stratified by Baseline Frailty
score on a scaleFrailNot/Intermediate Frail
Hamilton Depression Rating Scale: Stratified by Baseline Frailty15.1 ± 8.2311.6 ± 7.21
PrimaryHamilton Depression Rating Scale: Stratified by Baseline Frailty

Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

Time frame:
Month 6
Reported as:
Mean · score on a scale
Hamilton Depression Rating Scale: Stratified by Baseline Frailty
score on a scaleFrailNot/Intermediate Frail
Hamilton Depression Rating Scale: Stratified by Baseline Frailty14.8 ± 8.6510.8 ± 5.85
PrimaryHamilton Depression Rating Scale: Stratified by Baseline Frailty

Measure Description: Our target is depressive symptomatology as measured by the Hamilton Rating Scale for Depression (HRSD). The HRSD is a 24-item questionnaire used as an indication of depression and a guide to evaluating recovery. Total scores range from 0-74, not including atypical symptoms sub-scale. A score above 16 is typically considered to indicate the presence of depressive symptoms. Higher scores indicate greater severity.

Time frame:
Month 12
Reported as:
Mean · score on a scale
Hamilton Depression Rating Scale: Stratified by Baseline Frailty
score on a scaleFrailNot/Intermediate Frail
Hamilton Depression Rating Scale: Stratified by Baseline Frailty14.3 ± 8.2113.0 ± 6.91
SecondaryWorld Health Organization Disability Assessment 2.0 (36-item)

Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

Time frame:
Baseline (Week 0)
Reported as:
Mean · score on a scale
World Health Organization Disability Assessment 2.0 (36-item)
score on a scaleMedication Treatment
World Health Organization Disability Assessment 2.0 (36-item)71.7 ± 24.8
SecondaryWorld Health Organization Disability Assessment 2.0 (36-item)

Assesses the level of functioning of patients, a component of the frailty evaluation. Simple: the scores assigned to each of the items - "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. This method is referred to as simple scoring because the scores from each of the items are simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. This approach is practical to use as a hand-scoring approach and may be the method of choice in busy clinical settings or in paper-pencil interview situations. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

Time frame:
Week 8
Reported as:
Mean · score on a scale
World Health Organization Disability Assessment 2.0 (36-item)
score on a scaleMedication Treatment
World Health Organization Disability Assessment 2.0 (36-item)68.7 ± 21.6
SecondaryWorld Health Organization Disability Assessment 2.0 (36-item)

Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

Time frame:
6 Months
Reported as:
Mean · score on a scale
World Health Organization Disability Assessment 2.0 (36-item)
score on a scaleMedication Treatment
World Health Organization Disability Assessment 2.0 (36-item)66.7 ± 20.9
SecondaryWorld Health Organization Disability Assessment 2.0 (36-item)

Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

Time frame:
12 Months
Reported as:
Mean · score on a scale
World Health Organization Disability Assessment 2.0 (36-item)
score on a scaleMedication Treatment
World Health Organization Disability Assessment 2.0 (36-item)67.8 ± 20.7
SecondaryWorld Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty

Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

Time frame:
Baseline (Week 0)
Reported as:
Mean · score on a scale
World Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty
score on a scaleFrailNot/Intermediate Frail
World Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty82.3 ± 24.156.8 ± 18.8
SecondaryWorld Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty

Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

Time frame:
Week 8
Reported as:
Mean · score on a scale
World Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty
score on a scaleFrailNot/Intermediate Frail
World Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty77.9 ± 22.859.4 ± 15.8
SecondaryWorld Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty

Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

Time frame:
Month 6
Reported as:
Mean · score on a scale
World Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty
score on a scaleFrailNot/Intermediate Frail
World Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty77.2 ± 19.958.0 ± 17.5
SecondaryWorld Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty

Assesses the level of functioning of patients, a component of the frailty evaluation. The scores assigned to each of the items: "none" (0), "mild" (1) "moderate" (2), "severe" (3), and "extreme" (4) - are summed. Each of the items is simply added up without recoding or collapsing of response categories; thus, there is no weighting of individual items. As a result, the simple sum of the scores of the items across all domains constitutes a statistic that is sufficient to describe the degree of functional limitations. Step 1 - Summing of recoded item scores within each domain. Step 2 - Summing of all six domain scores. Step 3 - Converting the summary score into a metric ranging from 0 to 100 (where 0 = no disability; 100 = full disability).

Time frame:
Month 12
Reported as:
Mean · score on a scale
World Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty
score on a scaleFrailNot/Intermediate Frail
World Health Organization Disability Assessment 2.0 (36-item)--Stratified by Baseline Frailty80.9 ± 18.156.7 ± 15.8

Adverse events

Collected over Adverse Events were collected for 12 months. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Medication Treatment-8 Weeks0/100 (0%)2/100 (2%)0/100 (0%)
Most frequent serious events
Most frequent serious events
EventMedication Treatment-8 Weeks
FallInjury, poisoning and procedural complications2/100

Baseline characteristics

Age, Continuous
Age, Continuous(years)Medication Treatment
Mean70.56 ± 7.59
Sex: Female, Male
Sex: Female, Male(Participants)Medication Treatment
Female66
Male34
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Medication Treatment
Hispanic or Latino12
Not Hispanic or Latino88
Unknown or Not Reported0
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Medication Treatment
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American17
White68
More than one race5
Unknown or Not Reported10
Region of Enrollment
Region of Enrollment(Participants)Medication Treatment
United States100
Hamilton Rating Scale for Depression (HRSD)
Hamilton Rating Scale for Depression (HRSD)(Score on a scale)Medication Treatment
Mean20.32 ± 5.84
08

Study locations

1 site
  • New York State Psychiatric Institute
    New York, New York 10032, United States
09

References and documents

Publications

  • Binder EF, Yarasheski KE, Steger-May K, Sinacore DR, Brown M, Schechtman KB, Holloszy JO. Effects of progressive resistance training on body composition in frail older adults: results of a randomized, controlled trial. J Gerontol A Biol Sci Med Sci. 2005 Nov;60(11):1425-31. doi: 10.1093/gerona/60.11.1425. PubMed 16339329 ↗
  • Brown M, Sinacore DR, Binder EF, Kohrt WM. Physical and performance measures for the identification of mild to moderate frailty. J Gerontol A Biol Sci Med Sci. 2000 Jun;55(6):M350-5. doi: 10.1093/gerona/55.6.m350. PubMed 10843356 ↗
  • Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA; Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56. doi: 10.1093/gerona/56.3.m146. PubMed 11253156 ↗
  • Brown PJ, Roose SP, O'Boyle KR, Ciarleglio A, Maas B, Igwe KC, Chung S, Gomez S, Naqvi M, Brickman AM, Rutherford BR. Frailty and Its Correlates in Adults With Late Life Depression. Am J Geriatr Psychiatry. 2020 Feb;28(2):145-154. doi: 10.1016/j.jagp.2019.10.005. Epub 2019 Oct 14. PubMed 31734083 ↗
  • Brown PJ, Ciarleglio A, Roose SP, Garcia CM, Chung S, Alvarez J, Stein A, Gomez S, Rutherford BR. Frailty Worsens Antidepressant Treatment Outcomes in Late Life Depression. Am J Geriatr Psychiatry. 2021 Sep;29(9):944-955. doi: 10.1016/j.jagp.2020.12.024. Epub 2020 Dec 25. PubMed 33388223 ↗

Study documents

  • Study protocol · Apr 6, 2020
  • Informed consent form · Oct 18, 2016
  • Statistical analysis plan · Nov 9, 2012

Documents are hosted by the registry — open the source record to download them.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 29, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT01973283
Lead sponsor
New York State Psychiatric Institute
Collaborators
National Institute of Mental Health (NIMH)
Responsible party
Patrick J. Brown (Associate Professor of Clinical Psychology (in Psychiatry), New York State Psychiatric Institute) — Principal investigator
First posted
Oct 31, 2013
Start date
Feb 19, 2014
Primary completion
Dec 5, 2019
Completion
Dec 5, 2020
Results posted
Jan 13, 2021
Last update
Jan 29, 2021

Study contacts

Patrick Brown, PhD
principal investigator · New York State Psychiatric Institute

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jan 2021. You cannot join it, but the record below documents what was studied.

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