|Title||Depressive symptoms in middle age and the development of later-life functional limitations: the long-term effect of depressive symptoms.|
|Publication Type||Journal Article|
|Year of Publication||2010|
|Authors||Covinsky, KE, Yaffe, K, Lindquist, K, Cherkasova, E, Yelin, E, Blazer, DG|
|Journal||J Am Geriatr Soc|
|Date Published||2010 Mar|
|Keywords||Activities of Daily Living, depression, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Mobility Limitation, Proportional Hazards Models, Prospective Studies, Risk Factors, United States|
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.
|User Guide Notes|
|Endnote Keywords|| |
Mobility/Older Adults/Middle Aged/Depression/Activities Of Daily Living/Geriatrics/Functional Assessment/Aging/FUNCTIONAL loss in older people/disability/disability/functional status/outcomes
|Endnote ID|| |
|Alternate Journal||J Am Geriatr Soc|
|PubMed Central ID||PMC2904810|
|Grant List||P60 AR053308 / AR / NIAMS NIH HHS / United States |
R01 AG028481-02S1 / AG / NIA NIH HHS / United States
R01 MH086498 / MH / NIMH NIH HHS / United States
R01 AG028481-03 / AG / NIA NIH HHS / United States
P60 AR053308-050003 / AR / NIAMS NIH HHS / United States
K24AG029812 / AG / NIA NIH HHS / United States
R01AG028481 / AG / NIA NIH HHS / United States
R01 AG028481-02 / AG / NIA NIH HHS / United States
K24 AG029812-03 / AG / NIA NIH HHS / United States
K24 AG029812 / AG / NIA NIH HHS / United States
R01 AG028481 / AG / NIA NIH HHS / United States