TY - JOUR
T1 - Association between lean muscle mass and treatment-resistant late-life depression in the IRL-GRey randomized controlled trial
AU - Ainsworth, Nicholas J.
AU - Brender, Ram
AU - Gotlieb, Neta
AU - Zhao, Haoyu
AU - Blumberger, Daniel M.
AU - Karp, Jordan F.
AU - Lenze, Eric J.
AU - Nicol, Ginger E.
AU - Reynolds, Charles F.
AU - Wang, Wei
AU - Mulsant, Benoit H.
N1 - Publisher Copyright:
© 2023 International Psychogeriatric Association.
PY - 2023/12/3
Y1 - 2023/12/3
N2 - Objective: To investigate the relationship between lean muscle mass and treatment response in treatment-resistant late-life depression (TR-LLD). We hypothesized that lower lean muscle mass would be associated with older age, higher physical comorbidities, higher depressive symptom severity, and poorer treatment response. Design: Secondary analysis of a randomized, placebo-controlled trial. Setting: Three academic hospitals in the United States and Canada. Participants: Adults aged 60+ years with major depressive disorder who did not remit following open treatment with venlafaxine extended-release (XR) (n = 178). Measurements: We estimated lean muscle mass using dual-energy X-ray absorptiometry (DEXA) scans prior to and following randomized treatment with aripiprazole or placebo added to venlafaxine XR. Multivariate regressions estimated influence of demographic and clinical factors on baseline lean muscle mass, and whether baseline lean muscle mass was associated with treatment response, adjusted for treatment arm. Results: Low lean muscle mass was present in 22 (12.4%) participants. Older age and female sex, but not depressive symptom severity, were independently associated with lower lean muscle mass at baseline. Marital status, baseline depressive symptom severity, and treatment group were associated with improvement of depressive symptoms in the randomized treatment phase. Baseline lean muscle mass was not associated with improvement, regardless of treatment group. Conclusion: As expected, older age and female sex were associated with lower lean muscle mass in TR-LLD. However, contrary to prior results in LLD, lean muscle mass was not associated with depression severity or outcome. This suggests that aripiprazole augmentation may be useful for TR-LLD, even in the presence of anomalous body composition. clinicaltrials.gov Identifier: NCT00892047.
AB - Objective: To investigate the relationship between lean muscle mass and treatment response in treatment-resistant late-life depression (TR-LLD). We hypothesized that lower lean muscle mass would be associated with older age, higher physical comorbidities, higher depressive symptom severity, and poorer treatment response. Design: Secondary analysis of a randomized, placebo-controlled trial. Setting: Three academic hospitals in the United States and Canada. Participants: Adults aged 60+ years with major depressive disorder who did not remit following open treatment with venlafaxine extended-release (XR) (n = 178). Measurements: We estimated lean muscle mass using dual-energy X-ray absorptiometry (DEXA) scans prior to and following randomized treatment with aripiprazole or placebo added to venlafaxine XR. Multivariate regressions estimated influence of demographic and clinical factors on baseline lean muscle mass, and whether baseline lean muscle mass was associated with treatment response, adjusted for treatment arm. Results: Low lean muscle mass was present in 22 (12.4%) participants. Older age and female sex, but not depressive symptom severity, were independently associated with lower lean muscle mass at baseline. Marital status, baseline depressive symptom severity, and treatment group were associated with improvement of depressive symptoms in the randomized treatment phase. Baseline lean muscle mass was not associated with improvement, regardless of treatment group. Conclusion: As expected, older age and female sex were associated with lower lean muscle mass in TR-LLD. However, contrary to prior results in LLD, lean muscle mass was not associated with depression severity or outcome. This suggests that aripiprazole augmentation may be useful for TR-LLD, even in the presence of anomalous body composition. clinicaltrials.gov Identifier: NCT00892047.
KW - aripiprazole
KW - body composition
KW - frailty
KW - late-life depression
KW - lean muscle mass
KW - treatment resistance
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U2 - 10.1017/S1041610222000862
DO - 10.1017/S1041610222000862
M3 - Article
C2 - 36594430
AN - SCOPUS:85182954443
SN - 1041-6102
VL - 35
SP - 707
EP - 716
JO - International Psychogeriatrics
JF - International Psychogeriatrics
IS - 12
ER -