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. 2010 Mar;58(3):551-6.
doi: 10.1111/j.1532-5415.2010.02723.x. Epub 2010 Feb 16.

Depressive symptoms in middle age and the development of later-life functional limitations: the long-term effect of depressive symptoms

Kenneth E Covinsky  1 , Kristine Yaffe, Karla Lindquist, Elena Cherkasova, Edward Yelin, Dan G Blazer
Affiliations

Depressive symptoms in middle age and the development of later-life functional limitations: the long-term effect of depressive symptoms

Kenneth E Covinsky et al. J Am Geriatr Soc. 2010 Mar.

Abstract

Objectives: To determine whether middle-aged persons with depressive symptoms are at higher risk for developing activity of daily living (ADL) and mobility limitations as they advance into older age than those without.

Design: Prospective cohort study.

Setting: The Health and Retirement Study (HRS), a nationally representative sample of people aged 50 to 61.

Participants: Seven thousand two hundred seven community living participants in the 1992 wave of the HRS.

Measurements: Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D 11), with scores of 9 or more (out of 33) classified as significant depressive symptoms. Difficulty with five ADLs and basic mobility tasks (walking several blocks or up one flight of stairs) was measured every 2 years through 2006. The primary outcome was persistent difficulty with ADLs or mobility, defined as difficulty in two consecutive waves.

Results: Eight hundred eighty-seven (12%) subjects scored 9 or higher on the CES-D 11 and were classified as having significant depressive symptoms. Over 12 years of follow-up, subjects with depressive symptoms were more likely to reach the primary outcome measure of persistent difficulty with mobility or difficulty with ADL function (45% vs 23%, Cox hazard ratio (HR)=2.33, 95% confidence interval (CI)=2.06-2.63). After adjusting for age, sex, measures of socioeconomic status, comorbid conditions, high body mass index, smoking, exercise, difficulty jogging 1 mile, and difficulty climbing several flights of stairs, the risk was attenuated but still statistically significant (Cox HR=1.44, 95% CI=1.25-1.66).

Conclusion: Depressive symptoms independently predict the development of persistent limitations in ADLs and mobility as middle-aged persons advance into later life. Middle-aged persons with depressive symptoms may be at greater risk for losing their functional independence as they age.

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Figures

Figure 1
Figure 1
Time to difficulty with activities of daily living or mobility (difficulty walking several blocks or up a flight of stairs) in subjects with and without depression.
See this image and copyright information in PMC

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References

    1. Covinsky KE, Palmer RM, Fortinsky RH, et al. Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. J Am Geriatr Soc. 2003;51(4):451–8. - PubMed
    1. Fried LP, Guralnik JM. Disability in older adults: evidence regarding significance, etiology, and risk. J Am Geriatr Soc. 1997;45(1):92–100. - PubMed
    1. Covinsky KE, Justice AC, Rosenthal GE, Palmer RM, Landefeld CS. Measuring prognosis and case mix in hospitalized elders. The importance of functional status. J Gen Intern Med. 1997;12(4):203–208. - PMC - PubMed
    1. Walter LC, Brand RJ, Counsell SR, et al. Development and validation of a prognostic index for 1-year mortality in older adults after hospitalization. Jama. 2001;285(23):2987–2994. - PubMed
    1. Gill TM, Robison JT, Tinetti ME. Difficulty and dependence: two components of the disability continuum among community-living older persons. Ann Intern Med. 1998;128(2):96–101. - PubMed

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